2023-2024 Beth-El Religious School Registration Form - Form

4900 BRIARHAVEN ROAD, FORT WORTH, TEXAS 76109
(817) 332- 7141 | FAX (817) 332-7157

2023-24 BETH-EL RELIGIOUS SCHOOL REGISTRATION FORM

IS THERE MORE THAN ONE ADULT MEMBER ON THE ACCOUNT?YesNo

PARENT/GUARDIAN CONTACT INFORMATION

* Primary Member - First Name

* Primary Member - Last Name

* Email Address

Mobile Phone Number

* Secondary Member - First Name

* Secondary Member - Last Name

* Email Address

Mobile Phone Number

HOME INFORMATION

* Address

* City

* State

* Zip

Home Phone

STUDENT INFORMATION

* How many Students are you registering for Religious School?

* Student 1 - Full Name

Student 1 - Hebrew Name

* Student 1 - Birthday

* Student 1 - T-Shirt Size

* What Grade is Student 1?

* Is this Student working with an approved B'nai Mitzvah Tutor?

STUDENT 1 - ENROLLMENT FEES

Religious School Tuition | $350
(Pre K-10th grade)

Mandatory Small-Group Hebrew | $305
(4th-7th grade)

Confirmation Fee | $140
(10th grade)

* Student 2 - Full Name

Student 2 - Hebrew Name

* Student 2 - Birthday

* Student 2 - T-Shirt Size

* What Grade is Student 2?

* Is this Student working with an outside Hebrew Tutor?

STUDENT 2 - ENROLLMENT FEES

Religious School Tuition | $350
(Pre K-10th grade)

Mandatory Small-Group Hebrew | $305
(4th-7th grade)

Confirmation Fee | $140
(10th grade)

* Student 3 - Full Name

Student 3 - Hebrew Name

* Student 3 - Birthday

* Student 3 - T-Shirt Size

* What Grade is Student 3?

* Is this Student working with an outside Hebrew Tutor?

STUDENT 3 - ENROLLMENT FEES

Religious School Tuition | $350
(Pre K-10th grade)

Mandatory Small-Group Hebrew | $305
(4th-7th grade)

Confirmation Fee | $140
(10th grade)

* Student 4 - Full Name

Student 4 - Hebrew Name

* Student 4 - Birthday

* Student 4 - T-Shirt Size

* What Grade is Student 4?

* Is this Student working with an outside Hebrew Tutor?

STUDENT 4 - ENROLLMENT FEES

Religious School Tuition | $350
(Pre K-10th grade)

Mandatory Small-Group Hebrew | $305
(4th-7th grade)

Confirmation Fee | $140
(10th grade)

EMERGENCY CONTACT INFORMATION

Parents will be contacted first in case of an emergency. Please give the names of two other people who can be notified in case you cannot be reached. Please also provide your child’s physician’s name and telephone number.

Emergency Contact 1 - Name

Phone

Relationship

Emergency Contact 2 - Name

Phone

Relationship

* Physician Name

* Physician Phone

Known Allergies:

Medications Taken:

PHOTOGRAPH USE PERMISSION

* I authorize Beth-El Congregation to use my family’s or my child’s photograph on its website or in official Beth-El publications without further consideration.

Please Select an Answer BelowYesNo

ADDITIONAL FEES & OPTIONAL DONATION

Curriculum Fee | $35
(per family)

Additional Contribution to the Beth-El Religious School

(suggested donation is $36)

FINANCIAL ASSISTANCE

No one will be denied an education to Religious School due to financial circumstances. If tuition is a genuine hardship for you, please select the checkbox below and Amy Robbins, Executive Director, will be in touch with you to have a confidential conversation.

When you get to the payment gateway, select Bill My Account. Once you talk with the Executive Director an adjustment will be applied to your account and you will be notified to set up your payment(s).

I will require Financial Assistance for the 2023-24 Religious School year

TOTAL DUE

Grand Total to the Beth-El Religious School