2021-22 Amitim Registration Form

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Shalom,

We are thrilled that your child(ren) will be participating in Amitim! This is a two-year Jewish-life training program. While building this community cohort, students will learn the meanings and how to lead prayers for Shabbat morning, Jewish traditions and Jewish values for making life choices. Some students will also learn trope (how to chant Torah). Tuition includes meetings with the Rabbi to plan the ceremony and to write the student's drash. It also includes High Holy Day and special Amitim holiday celebrations. Many families will work additionally with a tutor or a mentor to help with a student's specific Torah leyning and to polish prayers.

Thank you for filling this registration form in full and submitting a deposit. We look forward to this program meeting once again in person this fall.

In order to celebrate a bar or bat mitzvah at Congregation Netivot Shalom, one must be halachically Jewish, as defined by the Conservative Movement (meaning born to a Jewish mother or converted) and must be a current member of the congregation.

Amitim will meet on Tuesdays 4:30-6:30 (except for holidays), beginning on August 24, 2021 and concluding on May 24, 2022 (Year two will end in May 2023).

In addition to our Tuesday classes, Amitim students will join together for Torah study throughout the year and will have a special track for the High Holy Days.

If you have any questions, please contact the Youth & Family Education Director, yfed@netivotshalom.org

* Child 1 - First Name

* Child 1 - Last Name

Child 1 - Hebrew Name

Parents' Hebrew Names

* Child 1 - Date of Birth

* Child 1 - After sunset?

Child 1 - Student Phone Number (if applicable)

Child 1 - Student Email Address (if applicable)

Child 1 - Grade in School

* Child 1 - Name of School

Health Insurance Carrier

Health Insurance Member Number (child 1)

Health Insurance Member Number (child 2)

Name of Primary Doctor

Dr / Health Insurance contact number

Emergency Contact Name and Number

* First Name - Parent/Guardian #1

* Last Name - Parent/Guardian #1

Hebrew Name - Parent/Guardian #1

Work Phone - Parent/Guardian #1

Home Phone - Parent/Guardian #1

* Cell Phone - Parent/Guardian #1

* Email - Parent/Guardian #1

* Home Address - Parent/Guardian #1

* City - Parent/Guardian #1

* State - Parent/Guardian #1

* Zip Code - Parent/Guardian #1

First Name - Parent/Guardian #2

Last Name - Parent/Guardian #2

Hebrew Name - Parent/Guardian #2

Work Phone - Parent/Guardian #2

Home Phone - Parent/Guardian #2

Cell Phone - Parent/Guardian #2

Email - Parent/Guardian #2

Home Address IF DIFFERENT - Parent/ Guardian #2

City - Parent/ Guardian #2

State - Parent/ Guardian #2

Zip - Parent/ Guardian #2

Child 2 - First Name

Child 2 - Last Name

Child 2 - Hebrew Name

Parents' Hebrew Names

Child 2 - Date of Birth

Child 2 - After sunset?

Child 2 - Student Phone Number (if applicable)

Child 2 - Student Email (if applicable)

Child 2 - Grade in School

Child 2 - Name of School

Tuition: $3,600 for 2 program years.

Tuition payment must be complete by the time of your child's bar or bat mitzvah ceremony.

A non-refundable deposit of $200 due with this registration and will go towards your tuition payment.

You have an option to set up a payment schedule. If you prefer to pay by check, mail it to the office. We do not currently have a way to bring a payment in person.

Payment in full at registration qualifies for a $200 discount (total tuition after discount: $3,400)

* Please make your payment choice

Please Select OneDeposit of $200Pay Full tuition now $3400 (Discount of $200)A non-refundable deposit of $200 is due with registration.
Your deposit goes toward tuition.

SCHOLARSHIP DONATION

In addition to my child’s tuition, I would like to make a donation to support Jewish learning for youth at CNS. My payment will include an additional donation to the Youth Education Fund

Agreement for participation in Congregation Netivot Shalom's Amitim Religious School program:

Students are enrolled and contracted for the time period from August 24, 2021 through May 2023. By completing this registration and making a deposit, I understand that my family is responsible for the entire tuition and that it will be paid in full before our child becomes Bar/Bat Mitzvah.

Netivot Shalom reserves the right to void this contract at the discretion of the Rabbi in consultation with the Executive Director. In such instances, the unused portion of any prepaid fees may or may not be refunded.

By clicking the "I agree" button and putting your name in the signature box, you agree that you understand and accept the parameters for participating in Amitim and for celebrating a bar or bat mitzvah with the congregation.

* By checking this box and putting my name in the signature box, "I agree" that I understand and accept the parameters for participating in Amitim and for celebrating a b'mitzvah with the congregation.

By checking this box and putting my name in the signature box, "I agree" that I understand and accept the parameters for participating in Amitim and for celebrating a b'mitzvah with the congregation.

* By checking this box I acknowledge that in order to celebrate a bar or bat mitzvah at Congregation Netivot Shalom, one must be halachically Jewish, as defined by the Conservative Movement (meaning born to a Jewish mother or converted) and must be a current member of the congregation.

By checking this box I acknowledge that in order to celebrate a bar or bat mitzvah at Congregation Netivot Shalom, one must be halachically Jewish, as defined by the Conservative Movement (meaning born to a Jewish mother or converted) and must be a current member of the congregation.

Check this box if you want a call to discuss membership, family circumstances, such as two-household parents, custody, or finances - with the Executive Director.Check this box if you want a call to discuss any accommodations we can make to the learning environment to help your child - with the Youth & Family Education Director.I would like to speak with the Rabbi about my child's halachic status as defined by the Conservative Movement.

First Name

Last Name

Total

Mon, October 25 2021 19 Cheshvan 5782