ARS 8th-9th Grade Registration 2023-2024 - Form

Join your 8^th & 9^th grade friends on Tuesday evenings for dinner and community time with Rabbi Queen and ARS teacher Jen Whitman!
Based on students' requests, the teens will have dinner weekly with Jen Whitman and Rabbi Queen, and then will spend time learning about Jewish values, and watching favorite tv shows to see how the values play out.
Classes will run from 6-7:30pm on Tuesday evenings.

Class costs $500 for members, and $625 for non-members. Class will begin in the fall and all registrants will receive an email with class dates as we get closer. Please reach out to Amy Deutsch with any questions.

Emergency Contact Information

* Emergency Contact 1 (full name)

* Emergency Contact 1 Email

* Emergency Contact 1 Phone

* Emergency Contact 2 (full name)

* Emergency Contact 2 Email

* Emergency Contact 2 Phone

* Are you members of TOS?

Please Select OneYesNo

How many students are you registering?

Please Select One1 Student2 Students

How many students are you registering?

Please Select One1 Student2 Students

Student Information

Student 1 Information

STUDENT 1 First Name

STUDENT 1 Last Name

STUDENT 1 Grade (2023-2024)

STUDENT 1 Email (if applicable)

STUDENT 1 Phone (if applicable)

Does STUDENT 1 have any allergies or medications we need to know about?

Please Select OneYesNo

STUDENT 1 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an Epi-Pen?

Please Select OneYesNo

STUDENT 1 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

STUDENT 1 Special Learning Needs

Please Select OneYes (IEP, 504 Plan, ICAP)NoMy student does not have an IEP but needs specific learning supports

If your student has an IEP, ICAP or 504, please CLICK HERE to send documentation to Amy Deutsch.

If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Student 2 Information

STUDENT 2 First Name

STUDENT 2 Last Name

STUDENT 2 Grade (2023-2024)

STUDENT 2 Email (if applicable)

STUDENT 2 Phone (if applicable)

Does STUDENT 2 have any allergies or medications we need to know about?

Please Select OneYesNo

STUDENT 2 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an Epi-Pen?

Please Select OneYesNo

STUDENT 2 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

STUDENT 2 Special Learning Needs

Please Select OneYes (IEP, 504 Plan, ICAP)NoMy student does not have an IEP but needs specific learning supports

If your student has an IEP, ICAP or 504, please CLICK HERE to send documentation to Amy Deutsch.

If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Student Information

Student 1 Information

STUDENT 1 First Name

STUDENT 1 Last Name

STUDENT 1 Grade (2023-2024)

STUDENT 1 Email (if applicable)

STUDENT 1 Phone (if applicable)

Does STUDENT 1 have any allergies or medications we need to know about?

Please Select OneYesNo

STUDENT 1 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an Epi-Pen?

Please Select OneYesNo

STUDENT 1 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

STUDENT 1 Special Learning Needs

Please Select OneYes (IEP, 504 Plan, ICAP)NoMy student does not have an IEP but needs specific learning supports

If your student has an IEP, ICAP or 504, please CLICK HERE to send documentation to Amy Deutsch.

If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Student 2 Information

STUDENT 2 First Name

STUDENT 2 Last Name

STUDENT 2 Grade (2023-2024)

STUDENT 2 Email (if applicable)

STUDENT 2 Phone (if applicable)

Does STUDENT 2 have any allergies or medications we need to know about?

Please Select OneYesNo

STUDENT 2 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an Epi-Pen?

Please Select OneYesNo

STUDENT 2 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

STUDENT 2 Special Learning Needs

Please Select OneYes (IEP, 504 Plan, ICAP)NoMy student does not have an IEP but needs specific learning supports

If your student has an IEP, ICAP or 504, please CLICK HERE to send documentation to Amy Deutsch.

If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Financial Assistance

There are many impediments to Jewish education but finances should never be one. We ask that every family commits to some financial contribution, however we are very happy to discuss financial aid options for any dues paying family that may require tuition assistance. If you require financial assistance, you will discuss your payment ability in a confidential meeting with Amy Deutsch, the Ansin Religious School Director.

* Are you interested in making a donation to help cover scholarship for other interested teens?

Please Select OneYes, I would like to make an additional donation.Not at this time, but thank you for asking.

How much would you like to donate?

The amount you list above will automatically be added to your total. Thank you so much for your generosity!

Release Forms

Medical Release

This health history is correct as far as I know. The person(s) herein described has my permission to engage in all prescribed activities except as noted above. I release Ohabei Shalom and its staff from all responsibilities other than classes, programs, and supervised and scheduled activities. In the event that I cannot be reached in an emergency, I hereby authorize the physician selected by the Ohabei Shalom Religious School Directors to hospitalize, secure proper treatment for and order injections, anesthesia, or surgery for my child named above.

* Medical Release: Enter your name below

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

Photo/Media Release

The Ansin Religious School of Temple Ohabei Shalom may use any individual or group photographs, written comments, video and/or audio recordings, taken at Temple Ohabei Shalom or elsewhere, documenting student in-school or out of school activities, for the purpose of promoting student enrollment and/or advertising the school, including, without limitation, on the Temple Ohabei Shalom website. TOS Staff is aware of the legal, moral, and ethical issues surrounding images of students in the public domain and will comply with all necessary guidelines.

* Photo/Media Release: Enter your name below

By typing my name, I confirm I have read, understand and agree to the above. If you do not grant permission for your student's image to be used, please email Amy Deutsch.

Universal Permission Slip

My student(s) has my permission to participate in field trips and youth group events planned by the Ansin Religious School of Ohabei Shalom during the 2023-2024 academic year. I understand that all trips will be adequately supervised and that transportation will either be by parental carpools, school buses, the MBTA or walking and that I will be informed beforehand of all such trips.

* Universal Permission Slip: Enter your name below

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

Immunization Record

Please upload the form from your child's annual physical at the pediatrician, including all immunizations. (All students must be fully immunized according to CDC policies.) It is also TOS policy that all students are fully vaccinated against COVID-19.

* Immunization Record

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