2022-2024 Amitim Registration

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Shalom,

We are thrilled that your child(ren) will participate 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. 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.

In order to celebrate a b'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 with orientation on August 30, 2022 and concluding on May 23, 2023 (Year two will end in May 2024).

In addition to our Tuesday classes, Amitim students will join together for Family Education programs, Torah study, and more throughout the year.

If you have any questions, please contact the Rebecca Goodman, Youth & Family Education Director, rebecca@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 - Entering Grade Fall 2022

* 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

Tuition: $3,600 for 2 program years.

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

A non-refundable deposit of $200 due with this registration and will go toward 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.

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 b'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 b'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.Check this box if you would like to speak with the Rabbi about your child's halachic status as defined by the Conservative Movement.Check this box if you DO NOT grant permission to Netivot Shalom to use the registered child(ren)'s photograph/video in conjunction with marketing, publicity and advertising on behalf of Netivot Shalom. In addition, I will hold Netivot Shalom harmless for

First Name

Last Name

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Tue, October 15 2024 13 Tishrei 5785