Journey Registration 2023-2024

Parent/Guardian Information

* Parent #1 First Name:

* Parent #1 Last Name:

Parent #2 First Name:

Parent #2 Last Name:

We will communicate by both email and text.

* Phone Number Parent #1:

Phone Number Parent #2

* Email Address Parent #1

Email Address for Parent #2

* Address

Address Line 2

City

* State

* Zip

Child Information

* Child's First Name:

* Child's Last Name:

Child's Hebrew Name:

* Child's grade during the 2023-2024 school year:

* Child's Birthdate

* Child's Gender

I give CSK permission to use my child's/children's picture in publications such as the CSK Website, Facebook, the Jewish Herald Voice, etc.

YesNo

Tuition

* Please select tuition amount from options below:

PLEASE NOTE: When you submit this form, you will be prompted to make an immediate payment via a credit/debit card OR have your child's tuition billed to your account.

If you are signed into your account, you can set up a payment plan by choosing the option above and click on how often you would like to be billed.

If you are not signed into your account, and you choose the "bill my account" option, please submit and then click on "my account" at the top of your screen. You will be prompted to set up a payment plan on a schedule that works for you starting between now and five days from now. If you need longer than five days to make your first payment, please simply revisit the "my account" section when you are ready to set up your payment plan. If you want to pay by check, select Bill my Account" and submit your check to Shma Koleinu PO Box 1808 Bellaire, TX 77402

* Please select how you would like to pay:

I am interested in learning more about financial-need scholarships for Journey.

We Need You!

We are always looking for volunteers to help lead, facilitate and participate Journey program events.

Do you like to work with kids? Can you read Hebrew (sound out consonants and vowels)? How about working with teenagers? Are you artistic? Do you like gardening? Can you sing or play guitar? Can you cook/bake?

If you have any of these (or other!) talents, please let us know in the space below.

Note: All adult teachers (volunteer and paid) will be required to undergo a background check.

Tell us a little about yourself. How would you like to be involved in the Journey Program? (optional)

Thank you for enrolling your child in Journey, the Jewish Discovery Project at Shma Koleinu!

To enroll an additional child, please complete a separate registration form.

- The Shma Koleinu Journey Team

Sun, September 24 2023 9 Tishrei 5784