WJC Family School Registration Form - Form - Woodstock Jewish Congregation

Learner's Information

* Is this learner under the age of 18?

* This learner would like to attend:

Please Select OneWeekly, Wednesdays, 4:00 - 6:30 pmPreK - 1st Grade, Once a Month Saturday ProgramB'Mitzvah Program

This Learner would like to attend

Weekly, Wednesdays, 4:00 - 6:30 pm

* Learner's First Name

* Learner's Last Name

* Learner's First Name

* Learner's Last Name

* Learner's Email Address

* Learner's Phone Number

* Date of Birth

* Gender

* Pronouns

* Grade in Secular School

* Secular School Name

* Secular School District

* Primary Healthcare Provider

* Primary Healthcare Provider Phone Number

* Any health condition(s)/allergies/dietary restrictions? If None, Type N/A

* Please List Medications & Other Health Concerns. If None, Type N/A

* In the event that no one can be reached, I/we give permission for the staff of WJC to take whatever emergency measures are necessary.

Please Select OneYesNo

COVID-19 Safety Protocols
This continues to be an evolving situation and the WJC board is regularly evaluating our COVID policies. We will require masks indoors when we are in medium or high transmission rates, based on the Covid Community Transmission Level in Ulster County according to the CDC dashboard. Additionally, we will be spending as much time outside as possible. Please note: While we are not requiring the COVID vaccine for Family School participants at this time, the WJC requires COVID-19 vaccinations for any shul-wide program (other than family school). If you plan on attending a shul program please keep this in mind.

Vaccination Records
The family school requires vaccinations in line with New York state requirements which include;

Diphtheria and Tetanus toxoid-containing vaccine and Pertussis vaccine (DTaP or Tdap)
Hepatitis B vaccine
Measles, Mumps and Rubella vaccine (MMR)
Polio vaccine
Varicella (Chickenpox) vaccine

* Please upload a copy of the learner’s immunization record:

COVID-19 Safety Protocols

Covid-19 continues to be an evolving situation and the WJC board is regularly evaluating our Covid policies. The Family School will require masks indoors when we are in medium or high transmission rates, based on the Covid Community Transmission Level in Ulster County according to the CDC dashboard.

Additionally, we will be spending as much time outside as possible.

Proof of Covid vaccination is required for all learners in the Family School over the age of 18. We appreciate your compliance with this policy.

* Please upload a copy of the learner's Covid vaccination record:

We are committed to creating an inclusive learning environment. Please share any and all helpful information about this learner so that we can best support them in a successful year. If you are more comfortable meeting to discuss this, please indicate below.

* Please describe the learner's experience and comfort level with Hebrew

Parent/Guardian Information

* Adult/Guardian 1: First Name

* Adult/Guardian 1: Last Name

* Adult/Guardian 1: Relationship to Learner

* Adult/Guardian 1: Email

* Adult/Guardian 1: Phone Number

Is there another parent/guardian?

YesNo

Adult/Guardian 2: First Name

Adult/Guardian 2: Last Name

Adult/Guardian 2: Relationship to Learner

Adult/Guardian 2: Email

Adult/Guardian 2: Phone Number

Emergency Contacts

In case of emergency, we will contact Adults 1 and 2 listed above. If there are ADDITIONAL Emergency Contacts, please list them below, including NAME, PHONE NUMBER, & RELATIONSHIP TO STUDENT

Media Release

* Media Release: Photos and video are often taken during family school and other shul programs. We would like your permission to use this media on our website, social media, newsletter, and occasionally on flyers and ads or other promotional items. Images will not be identified with any names.

Please Select OneYES, I give permissionNO, I DO NOT give permissionPlease note you may rescind your release at any time by submitting a written request to the main office.

Membership

* All learner families, older than 1st grade, must be synagogue members in good standing.

Please Select OneI/We are members in good standingI/We are not members and would like to be contacted regarding membership

* Today's Date

Payment

B'Mitzvah Program

Tuition for our B'Mitzvah Program is $1800. You are invited to pay in full today or any amount between $50 and $1800. If you choose to pay a portion today — we require a $50 minimum payment — we will bill you for the balance.

Please indicate, below, the amount you would like to pay today. We will bill you for the balance.

Thank you so much! We look forward to an exciting year together!

Payment

Saturday Pre-K Shabbat Program

Tuition for our monthly Saturday Pre-K Shabbat Program is $218. We require a minimum payment of $50 with this registration. If you are not paying in full today, we will bill you for the balance.

Thank you so much for registering your learner! We look forward to sharing Shabbat with you this year!

Payment

Weekly Program

The 2022-2023 tuition for Family School is $655. There is a required deposit of $50 upon submitting this registration, and you do need to be a member in good standing to participate in the Family School past 1st grade. The WJC is committed to cost not being a barrier to Jewish engagement and aspires to remove any barriers to accessing reduced tuition. We also are committed to being transparent about the cost connected with running our learning programs.

Tuition covers a portion of what it costs to run our Family School and is subsidized by WJC membership and fundraising. The actual cost to run our program per student is approximately $2,150.00 for the year. In addition to our commitment to transparency, we want to share these costs to encourage families to make a contribution that feels appropriate to their family. Below, you will be invited to write in what you would like to be charged for tuition and how you would like to be billed. In other words, those who can pay the full requested tuition amount of $655 should enroll at that level. Those who need assistance should request it by indicating the amount you feel you can contribute this year. Any family who feels they can make an additional contribution above the requested amount of $655 is welcome to do so, with gratitude.

Please let us know, below, the amount you would like to pay in tuition and how much you would like to be charged today. If you are not paying in full, we will bill you for the balance.

There is a minimum payment of $50 with this registration form.

Thank you so much for enrolling in our Family School! We look forward to an exciting and enriching year together!

Payment

Weekly Program

The 2022-2023 tuition for Family School is $655. There is a required deposit of $50 upon registration, and you do need to be a member in good standing to participate in the Family School past 1st grade. The WJC is committed to cost not being a barrier to Jewish engagement and aspires to remove any barriers to accessing reduced tuition. We also are committed to being transparent about the cost connected with running our learning programs.

Tuition covers a portion of what it costs to run our Family School and is subsidized by WJC membership and fundraising. The actual cost to run our program per student is approximately $2,150.00 for the year. In addition to our commitment to transparency, we want to share these costs to encourage families to make a contribution that feels appropriate to their family. When you register, you will be invited to write in what you would like to be charged for tuition and how you would like to be billed. In other words, those who can pay the full requested tuition amount of $655 should enroll at that level. Those who need assistance should request it by indicating the amount you feel you can contribute this year. Any family who feels they can make an additional contribution above the requested amount of $655 is welcome to do so, with gratitude.

Please let us know, below, the amount you would like to pay in tuition and how much you would like to be charged today. If you are not paying in full, we will bill you for the balance.

There is a minimum payment of $50 with this registration form.

Thank you so much for enrolling in our Family School! We look forward to an exciting and enriching year together!

Please indicate the amount that you would like to pay for Family School tuition:

* Please indicate the amount that you would like to pay for Family School tuition:

* Please enter an amount (between $50 and $1800) that you will be paying today:

* Please enter an amount (between $50 and $218) that you will be paying today:

* Please enter an amount (between $50 and $2150) that you will be paying today:

* Please enter an amount ($50 and $2150) that you will be paying today: