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Yesod Program Enrolment Form


Student Details

Only if Jewish
Only if Jewish

Preferred Class Session

Please select up to two options 

Parent Details


Emergency Contact and Medical Information

If none, please write N/A.
If none, please write N/A.
If none, please write N/A.
In the event of an emergency involving my child I give my consent for Emanuel Synagogue (Hebrew & Religion School) to seek and administer the appropriate medical care at my expense, with the understanding that I will be notified as soon as possible of any such incident.

Permissions

I give permission for my child’s photos or student work, including my child/children’s names, to be used in communications about the Yesod Program (Emanuel Synagogue Beit Midrash). This may include publicity in Emanuel Synagogue newsletters, the Australian Jewish News, the Emanuel Synagogue website and other similar publications.
Parents must notify the school if their child is withdrawn from the Yesod Program (Emanuel Synagogue Beit Midrash) for any reason at any time. In the event of my child leaving the Beit Midrash I agree to notify the Head of Youth Education, by email or in writing, prior to the commencement of the next term.
I agree that neither Emanuel Synagogue, Emanuel Synagogue Beit Midrash, nor the Board of Progressive Jewish Education (BPJE) will be responsible for any injury or loss which my child may suffer while attending the school. I accordingly hereby release Emanuel Synagogue, Emanuel Synagogue Beit Midrash and BPJE, as well as any of its officers, staff (both administrative and nonadministrative) from any liability for any such injury or loss and indemnify each of them against all actions, claims or proceedings which may be brought against all or any of them by reason thereof.
Acknowledgement of Above Sections
You can upload a maximum of 1 files.
Payment Section

The cost per term is $330. Please note that you will be automatically billed each term to the credit card details provided below, unless you have provided written notification of intended withdrawal as per point number 2 under permissions above.

Wed, 17 April 2024 9 Nisan 5784