Sign In
Forgot Password
or Sign In With
Powered By
ShulCloud
Login
Membership & Account Renewal 2023-2024
Donate
Calendar
HOME
CONNECT
About Us
Join Our Community
Clergy
Staff
Board of Trustees
Events
Lifecycles
Men of Kol Ami
Women of Kol Ami
Judaica Shop
Learning
Strauss ECE
Jewish Lifelong Learning
Religious School
Worship
Prayerbook
Shabbat and Virtual Links
Livestream Shabbat Services
Membership & Account Renewal 2023-2024
Donate
Calendar
Religious School Registration 2023-2024
Please verify reCaptcha before submitting the form.
We are a
Please Select One
Returning Family
New Family
Early Bird Registration Enrollment Fee: We are registering
Please Select One
1 Student ($100)
2 Students ($150)
3 Students ($200)
4 Students ($250)
5 Students ($300)
Regular Registration Enrollment Fee: We are registering
Please Select One
1 Student ($200)
2 Students ($300)
3 Students ($400)
4 Students ($500)
5 Students ($600)
New Family Registration Enrollment Fee: We are registering
Please Select One
1 Student ($100)
2 Students ($150)
3 Students ($200)
4 Students ($250)
5 Students ($300)
We are registering
FAMILY INFORMATION
ADDRESS INFORMATION
- Please list your home address below. If you would like a separate mailing address added to your account, please reply to the confirmation message you get after submitting this form or email
kolami@katucson.org
.
*
Street Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
Home Phone Number
Please leave this line blank if you have no home phone.
PRIMARY ADULT INFORMATION
- The
primary adult
will be the first contact person in case of emergency and is used for primary contact from the congregation. However, both adults will receive the same school and class communications. This person can be switched at any time.
*
Primary Adult First Name
*
Primary Adult Last Name
Primary Adult Preferred Pronouns
*
Primary Adult Mobile Phone
*
Primary Adult Email Address
*
What is the primary adult's relationship to the student(s)?
i.e. Mom, Dad, Guardian, Grandparent, etc.
*
Would the primary adult like to join the Youth Education Committee?
Please Select One
Yes
No
Maybe, please send me more info
SECONDARY ADULT INFORMATION
- The
secondary adult
will be the second contact person in case of emergency. However, both adults will receive the same school and class communications. This person can be switched at any time.
Secondary Adult First Name
Secondary Adult Last Name
Secondary Adult Mobile
Secondary Adult Email Address
What is the secondary adult's relationship to the student (s)?
i.e. Mom, Dad, Guardian, Grandparent, etc.
Would the secondary adult like to join the Youth Education Comittee?
Yes
No
Maybe, please send me more info
STUDENT ONE
*
Student 1 First Name
*
Student 1 Last Name
Student 1 Preferred Pronouns
*
Student 1 Date of Birth
*
Student 1 Hebrew Name
Please use your regular keyboard, not the screen keyboard
*
Student 1 Grade in 2023-2024
Please Select One
Preschool (4 years old) - $325
Kindergarten - $325
First Grade - $500
Second Grade - $500
Third Grade - $650
Fourth Grade - $650
Fifth Grade - $650
Sixth Grade - $650
Seventh Grade - $650
Eighth Grade - $500
Ninth Grade - $350
Ninth Grade with Madrichim Training ($450)
Confirmation Tenth Grade ($350)
Confirmation Tenth Grade with Madrichim Training ($450)
Students entering 7th Grade will also be billed a B'nai Mitzvah Fee ($1100)
No, my student is not having a B'nai Mitzvah this year
Yes, my student is entering the B'nai Mitzvah program this year
Student 1 Email Address
*
Student 1 Weekday School
Student 1 Weekday School Grade
*
Does the student have any allergies (food or other)? If YES, please describe symptoms, name foods or other to be avoided, and the procedure to follow if reaction occurs:
*
Is there any physical condition that we should be aware of and what precautions should be taken (i.e. hearing impairment, etc.)? If YES, please list the condition(s) and what precautions should be taken:
*
Do we have permission to give your student over the counter medication?
Please Select One
YES
NO
Such as Ibuprofen, Tylenol, or Acetaminophen.
*
Does your student have additional needs we should be aware of?
*
Would you like to be contacted by our Inclusion Director?
Please Select One
YES
NO
*
Does your student have permission to attend field trips?
Please Select One
YES
NO
Information about the trips will be sent to families in advance.
STUDENT TWO
Student 2 First Name:
Student 2 Last Name
Student 2 Preferred Pronouns
Student 2 Date of Birth
Student 2 Hebrew Name
Please use your regular keyboard, not the screen keyboard
Student 2 Grade in 2023-2024
Please Select One
Preschool (4 years old) $325
Kindergarten ($325)
1st Grade ($500)
2nd Grade ($500)
3rd Grade ($650)
4th Grade ($650)
5th Grade ($650)
6th Grade ($650)
7th Grade ($650)
8th Grade ($500)
9th Grade ($350)
9th Grade with Madrichim Training ($450)
Confirmation 10th Grade ($350)
Confirmation 10th Grade with Madrichim Fees ($450)
Students entering 7th Grade will also be billed a B'nai Mitzvah Fee ($1100)
No, my student is not having a B'nai Mitzvah this year
Yes, my student is entering the B'nai Mitzvah program this year
Student 2 Email Address
Student 2 Weekday School
Student 2 Weekday School Grade
Does the student have any allergies (food or other)? If YES, please describe symptoms, name foods or other to be avoided, and the procedure to follow if reaction occurs:
Is there any physical condition that we should be aware of and what precautions should be taken (i.e. hearing impairment, etc.)? If YES, please list the condition(s) and what precautions should be taken:
Do we have permission to give your student over the counter medication?
Please Select One
YES
NO
Such as Ibuprofen, Tylenol, Acetaminophen
Does your student have additional needs we should be aware of?
Would you like to be contacted by our Inclusion Director?
Please Select One
YES
NO
Does your student have permission to attend field trips?
Please Select One
YES
NO
STUDENT THREE
Student 3 First Name
Student 3 Last Name
Student 3 Preferred Pronouns
Student 3 Date of Birth
Student 3 Hebrew Name
Please use your regular keyboard, not the screen keyboard
Student 3 Grade in 2023-2024
Please Select One
Preschool (4 Years old) ($325
Kindergarten ($325)
1st Grade ($500)
2nd Grade ($500)
3rd Grade ($650)
4th Grade ($650)
5th Grade ($650)
6th Grade ($650)
7th Grade ($650)
8th Grade ($500)
9th Grade ($350)
9th Grade with Madrichim Training ($450)
Confirmation (10th Grade) $350
Confirmation with Madrichim Training ($450)
Students entering 7th Grade will also be billed a B'nai Mitzvah Fee ($1100)
No, my student is not having a B'nei Mitzvah this year
Yes, my student is entering the B'nei Mitzvah program this year
Student 3 Email Address
Student 3 Weekday School
Student 3 Weekday School Grade
Does the student have any allergies (food or other)? If YES, please describe symptoms, name foods or other to be avoided, and the procedure to follow if reaction occurs:
Is there any physical condition that we should be aware of and what precautions should be taken (i.e. hearing impairment, etc.)? If YES, please list the condition(s) and what precautions should be taken:
Do we have permission to give your student over the counter medication?
Please Select One
YES
NO
Such as Ibuprofen, Tylenol, Acetaminophen
Does your student have additional needs we should be aware of?
Would you like to be contacted by our Inclusion Director?
Please Select One
YES
NO
Does your student have permission to attend field trips?
Please Select One
YES
NO
STUDENT FOUR
Student 4 First Name
Student 4 Last Name
Student 4 Preferred Pronouns
Student 4 Birth Date
Student 4 Hebrew Name
Please use your regular keyboard, not the screen keyboard
Student 4 in 2023-2024
Please Select One
Preschool (4 years old) ($325)
Kindergarten ($325)
1st Grade ($500)
2nd Grade ($500)
3rd Grade ($650)
4th Grade ($650)
5th Grade ($650)
6th Grade ($650)
7th Grade ($650)
8th Grade ($500)
9th Grade ($350)
9th Grade with Madrichim Training ($450)
Confirmation ($350)
Confirmation with Madrichim Training ($450)
Students entering 7th Grade will also be billed a B'nai Mitzvah Fee ($1100)
No, my student is not having a B'nai Mitzvah this year
Yes, my student is entering the B'nai Mitzvah program this year
Student 4 Email Address
Student 4 Weekday School
Student 4 Weekday School Grade
Does the student have any allergies (food or other)? If YES, please describe symptoms, name foods or other to be avoided, and the procedure to follow if reaction occurs:
Is there any physical condition that we should be aware of and what precautions should be taken (i.e. hearing impairment, etc.)? If YES, please list the condition(s) and what precautions should be taken:
Do we have permission to give your student over the counter medication?
Please Select One
YES
NO
Such as Tylenol, Ibuprofen, Acetaminophen
Does your student have additional needs we should be aware of?
Please Select One
YES
NO
Would you like to be contacted by our Inclusion Director?
Please Select One
YES
NO
STUDENT FIVE
Student 5 First Name
Student 5 Last Name
Student 5 Preferred Pronouns
Student 5 Birth Date
Student 5 Hebrew Name
Please use your regular keyboard, not the screen keyboard
Student 5 in 2023-2024
Please Select One
Preschool ($325)
Kindergarten ($325)
1st Grade ($500)
2nd Grade ($500)
3rd Grade ($650)
4th Grade ($650)
5th Grade ($650)
6th Grade ($650)
7th Grade ($650)
8th Grade ($500)
9th Grade ($350)
9th Grade with Madrichim Training ($450)
Confirmation 10th Grade ($350)
Confirmation 10th Grade with Madrichim Training ($450)
Students entering 7th Grade will also be billed a B'nai Mitzvah Fee ($1100)
No, my student is not having a B'nai Mitzvah this year
Yes, my student is entering the B'nai Mitzvah program this year
Student 5 Email Address
Student 5 Weekday School
Student 5 Weekday School Grade
Does the student have any allergies (food or other)? If YES, please describe symptoms, name foods or other to be avoided, and the procedure to follow if reaction occurs:
Is there any physical condition that we should be aware of and what precautions should be taken (i.e. hearing impairment, etc.)? If YES, please list the condition(s) and what precautions should be taken:
Do we have permission to give your student over the counter medication?
Please Select One
YES
NO
Such as Tylenol, Ibuprofen, Acetaminophen
Does your student have additional needs we should be aware of?
Please Select One
YES
NO
Would you like to be contacted by our Inclusion Director?
Please Select One
YES
NO
EMERGENCY CONTACTS
- In an emergency, we will first call the primary adult and then the secondary adult (listed above). In case we are unable to reach you, please list two DIFFERENT people whom we can contact.
*
Emergency Contact Name (1)
*
Emergency Contact Relationship (1)
*
Emergency Contact Phone Number (1)
*
Emergency Contact Name (2)
*
Emergency Contact Relationship (2)
*
Emergency Contact Phone Number (2)
FINANCIAL ASSISTANCE
- Fees associated with Religious School are separate from your Membership Commitment.
Note: Enrollment fees are not eligible for financial assistance and are non-refundable.
*
Will you require scholarship assistance?
Please Select One
YES
NO
What are the financial considerations we should be aware of?
You will be contacted by the Education Director upon submitting Financial Assistance Request.
*
Can your student(s) photos be used on the school and/or synagogue communications, social media, website, etc.?
Please Select One
YES
NO
Please note, if you and your family are attending an event at Kol Ami (outside of religious school hours) there is implied permission for photographs of you to be taken. If at any time you do not want your photo taken, please ask the person taking the photo or speak to a member of the Kol Ami staff for further assistance.
By submitting this form, in case of an emergency, I give permission to the Kol Ami staff to administer first aid or transfer my student to the nearest medical facility to receive care as needed. I give authority to any hospital or doctor to render immediate aid as might be required at the time for my student's health and safety.
THANK YOU FOR REGISTERING FOR KOL AMI RELIGIOUS SCHOOL. YOUR TOTAL FOR THE YEAR IS:
We look forward to seeing you when school starts!
PLEASE NOTE: Before checking out, make sure you have a Credit Card on file.
Registration Fee MUST be paid upon registration. We will charge the card on file. Tuition and B'nai Mitzvah fees can be billed later on if you choose to use the "Charge to my account" option.
Tue, June 6 2023 17 Sivan 5783
