Jewish Community Religious School of Central Oregon Registration Form

Parent/Guardian First name*

Parent/Guardian Last name*

Email*

Phone*

Address*

Address Line 2

City*

State*

Zip Code*

Do you belong to or have you contributed to any of the local congregations? Check all that apply:*

Chabad of Central Oregon

Congregation Shalom Bayit

Temple Beth Tikvah

None of the above

Child 1

Child 1 Name*

Child 1 grade in September 2024*

Child 1 Birthday*

Child's Doctor*

Doctor's Phone Number*

Emergency Contact Name*

Emergency Contact Phone*

Emergency Contact Relationship*

Choose the program(s) you are registering child 1 for:*

Sunday School (K-7th, meets twice a month on Sunday mornings)$324

Hebrew School (typically begins in 3rd grade, meets weekly after school)$300

Youth Group (grades 6 and above only)$50

Only if you selected Hebrew School above:

Which year of Hebrew will your child study in 2024-2025?

Students usually enter First Year Hebrew in 3rd grade or at 9-10 years old. Leave blank if you are unsure where to place your child.

Does your child have any allergies, medical issues or food restrictions?*

yes

If yes, please list below:

Is there anything you want your child's teacher to know about them or their learning style?*

yes

If yes, please explain below:

Contact

Bend, Oregon 97703

Tel: (954) 663-2770

Enter Your Name

Enter Your Email

Message

Thanks for submitting!

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