Student Registration Information

This Conversational Hebrew class is intended for Hebrew Day School graduates. Students will meet for two half hour sessions/week to review Hebrew vocabulary, grammar, and to practice conversational fluency through a variety of fun activities. This class is open to non-BIC members. If you have additional questions, please contact Mira Sussman, Director of Education.

For currently enrolled BIRS 8th grade students, this class is included in your tuition at no extra charge. Please email Mira Sussman to complete registration for this class.
If your student is in 9th grade, the cost is $550, and your student is eligible to participate in all other High School chugim for no additional cost.

Tuesday/Wednesday, October 27, 2020-March 24th, 2021
8th-9th grades: 5-5:30pm

* Is your family new to our school?

Please Select OneNoYes

Section A: Family Contact Information

* First Name (Primary)

* Last Name (Primary)

* Email (Primary)

* Phone (Primary)

* Relationship to Student(s) (Primary)

* Street Address (Primary)

Street Address Line 2 (Primary)

* City (Primary)

* State (Primary)

* ZIP (Primary)

* Is there a secondary contact?

Please Select OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf there is a secondary contact, all emails and mailings will go to both contacts. In case of urgent need, the primary contact will be notified first

* First Name (Secondary)

* Last Name (Secondary)

* Email (Secondary)

* Phone (Secondary)

* Relationship to Student(s) (Secondary)

* Street Address (Secondary)

Street Address Line 2 (Secondary)

* City (Secondary)

* State (Secondary)

* ZIP (Secondary)

* Emergency Contact Name

* Emergency Contact Phone

* Emergency Contact Relationship

Section B: Student Enrollment Information

* Do you require financial aid?

Please Select OneNoYesParents must apply to the Financial Vice-President each year for scholarships; otherwise they will be billed full tuition.

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

* Student 1 Hebrew Name

Student 1 Nickname (if applicable)

* Student 1 Grade at BIRS

This is the same as your child's grade for the 2020-2021 secular school year unless you have made other arrangements with the religious school office.

Grade at Secular School

* Student 1 Secular School Name

Student 1 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 1 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 1 Special Learning Needs

Please Select OneNoYes (IEP or 504)If yes, Mira Sussman would love to discuss with you the best way to meet your child's needs. If you are comfortable we invite you to send any documentation ahead of time to school@bethisrael-aa.org.

Any other skills or talents you might be willing to share?

Student 2 Information

* Student 2 First Name

* Student 2 Last Name

* Student 2 Birthdate

* Student 2 Hebrew Name

Student 2 Nickname (if applicable)

* Student 2 Grade in Religious School

This is the same as your child's grade for the 2020-2021 secular school year unless you have made other arrangements with the religious school office.

Grade at Secular School

* Student 2 Secular School Name

Student 2 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 2 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 2 Special Learning Needs

Any other skills or talents you might be willing to share?

Student 3 Information

* Student 3 First Name

* Student 3 Last Name

* Student 3 Birthdate

* Student 3 Hebrew Name

Student 3 Nickname (if applicable)

* Student 3 Grade in Religious School

This is the same as your child's grade for the 2020-2021 secular school year unless you have made other arrangements with the religious school office.

Grade at Secular School

* Student 3 Secular School Name

Student 3 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 3 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 3 Special Learning Needs

Any other skills or talents you might be willing to share?

Student 4 Information

* Student 4 First Name

* Student 4 Last Name

* Student 4 Birthdate

* Student 4 Hebrew Name

Student 4 Nickname (if applicable)

* Student 4 Grade in Religious School

This is the same as your child's grade for the 2020-2021 secular school year unless you have made other arrangements with the religious school office.

Grade at Secular School

* Student 4 Secular School Name

Student 4 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 4 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 4 Special Learning Needs

Any other skills or talents you might be willing to share?

Section C: Release Forms

By signing my name below, my child(ren) have permission to participate in the religious school of Beth Israel Congregation. In consideration of my child(ren)'s acceptance as a religious school student, I hereby waive any and all claims against Beth Israel Congregation, its agents and its employees that may arise out of any injury, loss or damage suffered by my child(ren) during any religious school activity. I hereby authorize the Director of Education, or person designated by the Director of Education, to obtain emergency medical care for my child(ren) in the event such care is indicated. I give my permission for my child(ren) to receive emergency medical care by any nurse, doctor, paramedic or member of a medical staff of a hospital licensed by the State of Michigan. I understand that every effort will be made to notify a parent/guardian prior to treatment.

I certify that my child(ren) is(are) in good physical health. They have my permission to participate in all activities that are part of the regular religious school program. Field trips may be arranged by Beth Israel Congregation, and transportation may include bus or vehicle driven by a classmate's parent or guardian.

* Medical Release: Enter your name below

By typing my name, I confirm I have read, understand and agree to the above.

Media Release

From time to time your child’s photo may be taken in our classrooms or special events. We use these photos in the synagogue newsletter (Mah Koreh), on our synagogue display boards, the BIC website as well as private Facebook groups and other publicity materials.

* I give my permission for my child(ren)'s photo to be used:

Please Select OneOn any materialsOn specific materials with my permissionI do not give my permission for my child’s image to be used

Section E: Payment Information

Scholarship Fund (Optional Donation)

Teacher Professional Development and Training (Optional Donation)

Total Amount

BIRS Conversational Hebrew 8th-9th Grade

Student Registration Information