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Beth Shalom Hebrew School Registration 2025
We’d like to get to know you and your family better. Please complete the Family Information section once for your family, and the About Your Child section once for each child. The person who provides this information must be a parent or legal guardian of the child/ren.
School fees for the 2025 school year are:
Beth Shalom members - No fee
Non Beth Shalom members - $200 per child per term.
Section 1. Family Information
Please complete one section below for each parent, step parent or guardian
Parent/Guardian 1
Parent/Guardian 1 name
First name
Last name
Relationship to child
Address
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Email address
Phone number
Are you or your partner a member of:
Beth Shalom (Please note - a fee of $200 per child per term is charged for non-members)
AHC
Other - please specify
Add a second Parent/Guardian
Parent/Guardian 2 Name
First name
Last name
Relationship to child
Person or Household Address
Same as primary
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Email address
Phone number
+ Add another
- Remove
About our Family
Tell us about your family, please. (For example, who are the members of your family? What part of the city do you live in? What jobs do parents hold? What languages are spoken? How present is Judaism in your home? In what ways is it present? If there are any other religions or cultures present in your home, please tell us more about how your family works.)
Please include any information about your family that you think might be relevant.
Goals for Jewish Learning - what do you want for your children?
On a scale of 1-5, 5 being “extremely important” and 1 being “not at all important, how important are the following to you?
Learning about Israel
Jewish Values (being a mensch)
Hebrew language
Jewish customs
Jewish spirituality (for example, meditation and theology)
Preparing for Bar/Bat/Bnei Mitzvah
Making Jewish friends
Being in a Jewish environment
Beth Shalom is a community. We thrive when community members take part in what we do. In what ways can you help with our school? Here are some ideas. Please tick as many as may apply.
Teacher
Hebrew
Jewish Values
Family Learning
Relief Teacher
“Point Person” on the day – helping set up, answering questions, keeping us on schedule, solving problems that may arise, etc. This need not be every Sunday – even once a term would help.
Arranging snack (regularly or occasionally)
Greeter
Guard - Standing with the Security Guard at the gate to admit people
Clean up (all families are expected to help tidy up, but it helps to have someone direct our efforts.)
Education Committee
Painting/Refreshing/Decorating our Classrooms
Organising social events for kids and families
Other - please specify
Do you have a child over 11?
Yes
No
If yes, would you like to hear more about (please select all that may apply):
Bar/Bat Mitzvah Preparation
Post Bar/Bat Mitzvah – learning and socialising for teenagers
Teacher’s Aides/Madrichim
In future terms, we would like to offer Family Learning. Families learn together -- all kids, parents, and grandparents, other people important to you. This could take place 2 - 4 times in the year on Sundays. Is this something you'd participate in?
Yes
No
Would you be willing to host a Shabbat dinner for another Beth Shalom family? (It doesn’t have to be kosher or fancy!)
Yes
No
What else should we know about your family?
Form Page Break #1
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Section 2. About Your Child
Please complete a separate section for EACH of the children in your household.
(There is provision on this form to enter details for up to 4 children. Please contact administrator@bethshalom.org.nz if you have more children to enrol)
Child 1
Your child's name
Child's Date of Birth
Child's preferred name and pronoun
Child's Year at School
Child's siblings (if any)
Tell us more about your child as a person and as a learner (interests, special abilities and needs, insights into their learning).
MEDICAL INFORMATION
Does your child have any allergies? (Include food, animal and medication allergies)
Does your child carry an Epipen?
Yes
No
Does your child have any chronic health issues? If yes, please describe
Does your child have any other conditions that might impact their experience at Beth Shalom? Please include both mental and physical health.
The more information we have, the better we can support your child. Does your child need support with any of the following?
Medication
Vision
Hearing
Dietary
Social interaction
Learning challenges
If applicable please elaborate on any of the above and/or other support required
What else should we know about your child?
Add another child
Additional child
Your child's name
Child's Date of Birth
Child's preferred name and pronoun
Child's Year at School
Child's siblings (if any)
Tell us about more your child as a person and as a learner (interests, special abilities and needs, insights into their learning).
MEDICAL INFORMATION
Does your child have any allergies? (Include food, animal and medication allergies)
Does your child carry an Epipen?
Yes
No
Does your child have any chronic health issues? If yes, please describe
Does your child have any other conditions that might impact their experience at Beth Shalom? Please include both mental and physical health.
The more information we have, the better we can support your child. Does your child need support with any of the following?
Medication
Vision
Hearing
Dietary
Social interaction
Learning challenges
If applicable please elaborate on any of the above and/or other support required
What else should we know about your child?
+ Add another
- Remove
Form Page Break #2
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Section 3. Privacy and Emergency Contact Information
Do we have your permission to use images of your family for the Yachad and Teruah newsletters.(No student photos will ever be shared on Face Book or social media).
*
Yes
No
Do we have your permission to use images of your family on social media and/or marketing of the synagogue and school?
*
Yes
No
Are there any custody arrangements the Hebrew School needs to know about?
*
Yes
No
If yes, please describe
In case of an emergency please list two people that the school can call?
Emergency Contact 1 (Name and relationship)
Phone number
Emergency Contact 2 (Name and relationship)
Phone number
Section 4. Acknowledgement
This information is being collected by Beth Shalom for the purpose of providing Jewish education for your child and communicating with you about what Jewish education we are offering. Your responses will be shared with Teachers, Rabbi, the Beth Shalom Education Committee, and Staff, and will be entered into our synagogue database. We will not share your responses with anyone else. You do not have to provide all of this information, but if you choose not to, your child may not be able to benefit from all that we have to offer. You have the right to request access to and/or request that we update and/or correct information that we hold about you and your child/ren by contacting us at administrator@bethshalom.org.nz
I consent to the information in this registration form being used by Beth Shalom for the purposes described above.
*
Signature of Parent/Guardian (Please print name)
*
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