2022-23 Youth and Family Engagement Registration

Tent Campaign ID

RS Campaign ID

PreK/Sandbox Campaign ID

Temple Israel Member

YesNo

Account ID

Member Registration

Welcome to the member registration system for Temple Israel Youth and Family Engagement Programs. Through this form you can register your child for:

Religious School (Sandbox-7th Grade)
Teen Education (The Tent, RYFTI Youth Group, Confirmation & Madrichim)

Please complete all registration sections and click the "submit" button before closing the registration page. The system will not automatically save along the way.

To register a child listed, please select "Yes" for the "Enroll this Child" field. If you do not wish to register a child, leave the "Enroll this Child" field as No. To add a child that is not currently listed - click the "Add Child" link.

Required fields are marked with a red asterisk [*].

Registration

Welcome to the non-member registration system for Temple Israel Youth and Family Engagement Programs. Through this form you can register your child for:

Religious School (Sandbox/Pre-K)
Teen Education (The Tent, RYFTI Youth Group, & Confirmation)

Required fields are marked with a red asterisk [*].

Child Information

Child First Name

Child Last Name

Child Date of Birth

Child Preferred Name

Child Hebrew Name

Child Gender Identity

Child Other Gender Identity

Child Pronouns

Child Other Pronouns

Child Cell Phone (if applicable)

Child Email (if applicable)

Enroll this child in:

Enrollment Details

Child Grade Level

Subtotal for Enrollment

Do you prefer onsite or online classes?

We understand that circumstances are changing, and you can change your answer at any time by emailing Emma at eglaser@tisrael.org.

Please select your day preference (Sunday 8-10 am or Tuesday/Thursday 4-6 pm):
Once a student is in 2nd grade, we require additional class time each week (Small Group Hebrew & Electives). We offer this additional learning time for students in Kindergarten & 1st grade students, but it is not required. Online classes will only be offered on Sundays this year.

Do you prefer onsite or online Hebrew Groups?

We understand that circumstances are changing, and you can change your answer at any time by emailing Roberta at raxeloons@tisrael.org.

Specialized Track Options: These classes will happen if we have at least 8 students signed up. Contact Roberta with questions or concerns.

General Religious SchoolSpecialized Track

	1 (Most Interested)	2	3	4	5 (Least Interested)
TI Scholars - for students looking for a deep dive into Jewish texts and Hebrew Language
TI Creative Arts - exploring Judaism through theater and art
TI Wilderness & Movement - an all-weather, outdoor, active, movement-based Jewish experience
Family Education - General Religious School, multi-modal learning with once-per-month parent-child learning programs

Are you interested in private or group tutorial for your child?

The Tutorial Program is designed to support students in Grades 3-7 who either cannot participate in weekday programming, or would benefit from individualized attention. The tutorial fee is $2,300 per student, which covers payment for 30 one-hour sessions with a tutor and the necessary administrative costs. Fees for group tutorial are dependent on the size of group. Contact Roberta Axeloons (raxeloons@tisrael.org) for more information. Please Note: The religious school tutoring program is NOT the same as B'nei Mitzvah Preparation Tutoring. Tutors for B'nei Mitzvah are arranged through Cantor Stillman's office.

Are you interested in Online Hebrew Learning for your child?

The Online Hebrew Learning Program supports students in Grades 3-7 in Hebrew learning who cannot regularly attend weekday classes, or would benefit from supplemental learning time. Please note the Online Learning Program is not designed to replace Sunday learning time. Enrollment in the Online Learning Program is $750.00 for the year, which includes access to the online learning portal, and regular virtual check-ins.

Are you interested in participating in Confirmation?

Are you joining the Tent on Monday nights?

There is a $600 participation fee

Are you new to The Tent?

Who referred you to The Tent?

Are you applying to the Madrichim Program?

Madrichim Program

Please read the Madrichim Program Policies before proceeding.

Select your T-Shirt Size (Unisex Adult Sizes)

Shift Preference (include all shifts for which you are available)

Sunday morningTuesday afternoonThursday afternooon

Which grade (K-6) would you prefer to teach? Rank your top three choices. (separate your choices by a comma)

Why are you interested in being a Classroom Madrich/a?

What qualities do you possess that you believe will help you in your role?

What has motivated you to seek an opportunity to develop the skills of a teacher?

Describe a memorable experience you had while working with younger children

Describe a difficult experience you had while working with younger children. What was the problem and what did you do about it? What did you learn from the experience?

Indicate that you have read and understand our Madrichim Program Policies. Acceptance of this statement is required for application.

I (We) Accept

Student Profile

What public/private school is your child currently attending?

What is your child doing this summer? If your child is involved with a summer camp, please tell us which camp.

What is your teen doing this summer? In particular, if your teen is involved with a summer camp, please tell us which camp, and if your teen traveled to Israel, please share a little about that trip.

What are your goals for your child's Jewish education at Temple Israel?

If your child received any Jewish education in the past please indicate it below:

What is your child's learning style? Do you have any advice for your child's teacher on how to be most successful in educating them?

Is there anything else you feel your child's teacher should know about them? (e.g. nickname, hobbies, interests etc.)

Please describe any situations that could affect your child's attendance. For example a sports season or regularly occurring vacations.

Does your child have any reading or language challenges? Do they receive support services in regular school?

Please list 1-2 class friend requests in order of preference. TI values parent input when we create Sunday class lists. We also strive to build an inclusive community across each grade, mixing up Sunday classes from year to year. We will do our best to honor 1-2 friend requests but cannot promise we can accommodate requests beyond this.

Does your child have an IEP or a 504 Accommodation Plan

YesNo

Please attach your IEP/504 Plan documentation here

Permissions

Media Permissions Policy Statement (Please choose the statement that works best for you.)

I grant permission to use any and all written comments, pictures, and/or videos in which my child appears for publicity, promotion, and advertising on behalf of Temple Israel of Boston and its programsI should be contacted for permission before any written comments, pictures, and/or videos in which my child appears are used for publicity, promotion, or advertising on behalf of Temple Israel of Boston and its programs. However, I do understand that my child may appear in a group photo, but will not be named or identified in any way.

Permission by:

Date

Educational Program Liability Release Statement

Activities in The Temple Israel Education program (including Sandbox & PreK classes, K-7 Religious School, TI Teen Education, and The Tent) may sometimes occur outside the building. Outings or class field trips may include transportation by walking, car, the T, or a bus. Parents always are notified in advance of any trip that requires a bus or car. I/we understand that the school will do all that it can to ensure the safety of our child.

By accepting, I/we release Temple Israel and all its personnel, employees, and representatives from liability in case of accident or injury resulting from all causes, except for those involving gross negligence or intentional misconduct on the part of such personnel, employees, and representatives. I/we empower the Temple Israel staff to act for me/us in accordance with their best judgment in case of an emergency, after unsuccessful attempts to reach the parent(s) or caregiver. In the event of an emergency, Temple Israel will always attempt to reach the parent(s) or caregiver first. I/we hereby authorize Temple Israel to transport my/our child by ambulance (or police) to the nearest hospital in order to obtain necessary medical treatment if Temple Israel cannot reach a parent.

I (We) Accept and release Temple Israel

Released by:

Date

Emergency/Medical Information

Child Physician's Name

Child Physician's Phone

Please list any food allergies and/or food restrictions

Please list any general allergies and/or allergies to medications

Does your child have any other medical conditions, or emotional or familial concerns of which we should be aware?

Current Medications

Please describe any needed restrictions on activity

I provide blanket consent for Temple Israel staff to dispense over the counter medication to my child, at my child's request

YesNo

Teen Medical Release statement:

I release The Tent, Temple Israel, and the staff from all responsibilities other than programs, included meals, and supervised and scheduled activities. In the event I cannot be reached in an emergency, I hereby authorize the physician selected by The Tent/Temple Israel to hospitalize, secure proper treatment for, and order injections, anesthesia, or surgery for my teen named above. By entering my name on this line/in this box I declare that the information submitted online is accurate to the best of my knowledge.

I (We) Accept

Released by:

Date

Is there is an additional household where the student(s) registered above spend any time living during the school year?

Additional Household

Parent/Caregiver 1

Parent/Caregiver First Name

Parent/Caregiver Last Name

Parent/Caregiver Email

Parent/Caregiver Mobile Phone

Relationship to Child

Street Address

City

State

Zip Code

Is there an additional adult in this household?

Parent/Caregiver 2

Parent/Caregiver First Name

Parent/Caregiver Last Name

Parent/Caregiver Email

Parent/Caregiver Mobile Phone

Relationship to Child

In Case of Emergency

Please provide/confirm the preferred contact information for a parent or caregiver who will be called first in case of an emergency.

Emergency Contact 1 Name

Emergency Contact 1 Relationship

Emergency Contact 1 Mobile Phone

Please provide/confirm the preferred contact information for a parent or caregiver who will be called second in case of an emergency.

Emergency Contact 2 Name

Emergency Contact 2 Relationship

Emergency Contact 2 Mobile Phone

Please provide/confirm the preferred contact information for a parent or caregiver who will be called third in case of an emergency.

Emergency Contact 3 Name

Emergency Contact 3 Relationship

Emergency Contact 3 Mobile Phone

Edit this text

I have reviewed the above information and confirm that it is correct.

Fees and Payment Options

To complete registration, please pay by credit card with the form below.

If you wish to set up recurring payments, or would like to request financial aid, please select "Contact Education Office" and email Emma Glaser at eglaser@tisrael.org.

Payment Method

Credit CardContact Education OfficeStaff Code

discountAmount

Staff Code

Total Charge for Enrollment

prediscountTotal

Credit Card Information

Billing First Name

Billing Last Name

Billing Email

Billing Street

Billing City

Billing State

Billing Zip

Card Number

Code

Expiration Month

Expiration Year

Total Primary Household Adults

Total Additional Household Adults

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Contact Information