Y'ladim BaTeva: Outdoor Jewish Learning for Kids Registration for 5785 / 2024-25

Please fill out this form individually for each child being registered.

Child's Full Name

Child's Grade in September 2024

Child's Age in September 2024

Child's Birthdate

Do you wish to enroll your child in the optional Hebrew language program?

Yes

No

I am not sure and would like to discuss it

If your child is new to Y'ladim BaTeva, what previous Jewish education does s/he/they have?

Does your child have a Jewish name? If so, what is it?

Please describe supports and strategies that help your child thrive in social and academic settings.

What pronouns does your child use?

What, if any, food or other allergies does your child have?

Is there anything else you would like us to know about your child or your family?

1st parent/guardian name

1st parent/guardian email

1st parent/guardian phone

2nd parent/guardian name

2nd parent/guardian email

2nd parent/guardian phone

Street Address

Town and Zip Code

Is there any other information we should have (e.g. 2nd parent/guardian address, family considerations, etc.)?

BY CHECKING THIS BOX , I indicate that that I have provided full and accurate information about my child as it relates to this child participating in the Y'ladim BaTeva - Outdoor Jewish Education for Kids program. I am aware that there are risks inherent to being outside, and I give permission for my child to be engaged in all program activities.

Ma'yan Tikvah

Y'ladim BaTeva Registration

Y'ladim BaTeva: Outdoor Jewish Learning for Kids Registration for 5785 / 2024-25