Leave this field empty

Religious School Registration 2025-2026/5786

We are excited that you have chosen Congregation B'nai Israel Religious School for your child's Jewish learning. Please fill out this form completely and remit with payment. Please complete all sections - each one must be opened. CLICK HERE FOR PARENT PORTAL

Registration of Students

* How many Children are you registering? For more than three please contact the business office for instructions.

One $450.00

Two $900.00

Three $1,350.00

* Full Name of Child 1

Hebrew Name

* Date of Birth

Student Email (If applicable)

* Name of Secular School

* Grade in School

* The Religious School is committed to making every reasonable accomodation to meet students' special learning needs, provided that they are disclosed. Information disclosed here will be accessible only to the Rabbi, Operations Manager, and the child's adult teacher(s), all of whom are charged to hold that information in confidence. Please enter any special needs here. If none, please enter NONE.

Full Name of Child 2

Hebrew Name

Date of Birth

Student Email (If applicable)

Name of Secular School

Grade in School

The Religious School is committed to making every reasonable accomodation to meet students' special learning needs, provided that they are disclosed. Information disclosed here will be accessible only to the Rabbi, Operations Manager, and the child's adult teacher(s), all of whom are charged to hold that information in confidence. Please enter any special needs here. If none, please enter NONE.

Full Name of Child 3

Hebrew Name

Date of Birth

Student Email (If applicable)

Name of Secular School and Grade in Secular School

Grade in School

Are any of these students new enrollees to the Religious School?

Family Information

Please fill out completely so we have the most accurate and up to date info for your family.

* Parent A Full Name

* Cell Phone

* Email

Parent B Full Name

Cell Phone

PRIMARY MAILING ADDRESS

* Street Address

Apartment or Unit Number

* City

* State

* Zip Code

I give consent for registered children to particpate in field trip(s) and to be transported by other parent volunteers.

Field Trip Consent

Yes

Does your child split time between two homes? If yes, would you like communication sent to both homes or only to primary? *

Please provide secondary mailing address, if applicable

Are there additional children in your home that will NOT be attending Religious School? If so please note name and age for children.

Name and Age of Child NOT attending

Medical and Emergency Contact

It is extremely important that in the event of a true emergency we have all relevant and updated information about your child(ren) to ensure they get the most accurate and quickest medical care possible; please fill out all info below.

* Do any of the enrolling students have a health condition that requires medication (please specify if daily); if yes, please note which child, what is the condition and what is the medication required (please note any inhalers or oral medication.) IF no medications, please type NONE.

* Do any of the enrolling children have a food or other allergy? If yes, please note which child. IF THIS IS A SEVERE FOOD ALLERGY PLEASE NOTE! IF no allergies, please type NONE

* Emergency Contact (MUST BE 18 OR OVER AND NOT LISTED AS PARENT OR GUARDIAN):

* Emergency Contact Cell Phone:

Policy Acknowledgments

I acknowledge that proof of immunization can be provided in compliance with the immunization policy of an Arkansas Public School District or of an accredited Arkansas private school.

Policy acknowledgment

Acknowledged

Temple policy regarding photographs of registered students: Congregation B'nai Israel may publish photographs of registered students, without name identification including but not limited to: the Chronicle, the Temple website, and the Temple Facebook page.

* Policy Acknowledgement

Acknowledged

* Policy Acknowledgement

Acknowledged

Volunteers For Temple B'nai Religious School

Options

Provide Snack items - indiv. wrapped and juice boxes

Religious School and holiday special program support

Purim - LAFTY Purim Carnival support

Substitute Teacher/helper

Payment information

* Would you like to sponsor one weeks security cost for religious school by adding on $180 to my religious school registration?

Yes $180.00

No $0.00

I prefer to pay by personal check via mail/drop off

Monthly ACH withdrawal

I am requesting need based scholarship.

We appreciate your registration and look forward to welcoming you on our Opening Day Sunday August 24, 2025 at 9:00 am! Confirmation Class begins on Wednesday, August 27.

* I have read and consent to the Congregation B'nai Religious School Policy found at https://www.bnai-israel.us/lifelong-learning/religious-school/parent-portal/

Acknowledged

Signature Line Text 1