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New Families: Ohav Sholom's Hebrew School
Please verify reCaptcha before submitting the form.
Child's Information
*
Child's first name
*
Child's Last name
*
Child's Hebrew name
*
Street address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip code
Cell phone number
*
Child's birthday
*
Public School Grade as of 9/24
*
Name of school
Gan - K
Alef -1
Bet -2
Gimmel - 3
Dalet - 4
Hay - 5
Vav - 6
Zayin - 7
Parent information
*
Mother's first name
*
Mother's Mobile Number
*
Mother's Email address
*
Please choose one:
Born Jewish
Converted
*
Father's first name
*
Father's Mobile number
*
Father's Email address
*
Please choose one:
Born Jewish
Converted
Are there any special learning needs the school should be aware of?
Are there any medical or personal needs the school should be aware of?
Physician's name
Physician's phone number
Emergency information:
Emergency contact #1: Name
Phone number
Relationship
Emergency contact #2: Name
Phone number
Relationship
*
In the event of a medical emergency, if I cannot be reached or my emergency contact listed above cannot be reached, Congregation Ohav Sholom has my permission to obtain Medical Treatment for my child by a physician the synagogue has on call. *
I allow Ohav Sholom to use my child(ren)'s photos on social media and/or other promotional materials.
(Inital to allow consent)
Additional Info/Requests/Questions
Wed, February 19 2025 21 Shevat 5785