ARS Registration 2023-2024 NEW STUDENTS

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Welcome to Temple Ohabei Shalom! We’re excited to have you enroll your student(s) in Ansin Religious School (ARS) for 2023-2024! Please note that you must be a member in good standing of Temple Ohabei Shalom to attend ARS (unless your student is in grades K-3 and you are doing our special Trial Year option). ARS tuition is $1600 per student this year.

ARS will meet on Tuesday afternoons in 2023-2024. More ARS tuition information can be found here.
Please email ars@ohabei.org with any questions. Thank you!

* Is your family NEW to TOS?

Please Select OneYesNo

Welcome! We are so happy to have you! Please also fill out this New Member Form. If you have any questions, please email Amy Deutsch.

https://templeohabeishalom.shulcloud.com/form/new-member-form

What can we do to support you as a new family?

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 OneYes, at the same address as the primary contact.Yes, but at a different address than the primary contact.No
If 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 1 Name

* Emergency Contact 1 Phone

* Emergency Contact 1 Relationship

* Emergency Contact 2 Name

* Emergency Contact 2 Phone Number

* Emergency Contact 2 Relationship

Section B: Student Enrollment Information

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Date of Birth

* Student 1 Pronouns

Pronouns are important! Here's a helpful resource.

Other

Student 1 Hebrew Name (if applicable)

Student 1 Nickname (if applicable)

* Student 1 Secular School Name

* Student 1 Grade in Religious School (2023-2024)

Please note, if your student is being enrolled in 5th and 6th grade, there will be a B'nei Mitzvah fee assessed this year. $800 for 5th grade and $850 for 6th grade. You will see the fee added to the bottom of the form. Payments cover the cost of our B’nei Mitzvah Experience family programming and tutoring in the 5th – 8th grade years.

* Will your student be doing a Trial Year?

Please Select OneYesNo
ARS Trial Year Option: For a new student in grades K, 1, 2, or 3, there is an option of the ARS Trial Year so that the family can get a sense of Temple Ohabei Shalom and see if it's right for them. The cost for this is $2350, and the Trial Year does not include any of the perks of synagogue membership like High Holy Day tickets. If the student comes back to ARS after the Trial Year, the family will join as members and pay dues at the Year 1 rate.

* Student 1 Allergies or Medications

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 Specific 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 your student has specific learning needs, please elaborate here.

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

Please Select OneYesNo

Please tell us anything we should know about learning supports that have helped your child in the past.

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Please feel free to tell us any other information that may help us to create the best environment for your student (talents you wish us to nurture; special family situations including joint custody, intermarriage; learning disabilities; health problems...)

Student 2 Information

Student 2 First Name

Student 2 Last Name

Student 2 Date of Birth

Student 2 Pronouns

Pronouns are important! Here's a helpful resource.

Other

Student 2 Hebrew Name (if applicable)

Student 2 Nickname (if applicable)

Student 2 Secular School Name

Student 2 Grade in Religious School (2023-2024)

Will your student be doing a Trial Year?

Please Select OneYesNoARS Trial Year Option: For a new student in grades K, 1, 2, or 3, there is an option of the ARS Trial Year so that the family can get a sense of Temple Ohabei Shalom and see if it's right for them. The cost for this is $2350, and the Trial Year does not include any of the perks of synagogue membership like High Holy Day tickets. If the student comes back to ARS after the Trial Year, the family will join as members and pay dues at the Year 1 rate.

Student 2 Allergies or Medications

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 Specific 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 your student has specific learning needs, please elaborate here.

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

Please Select OneYesNo

Please tell us anything we should know about learning supports that have helped your child in the past.

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Student 3 Information

Student 3 First Name

Student 3 Last Name

Student 3 Date of Birth

Student 3 Pronouns

Pronouns are important! Here's a helpful resource.

Other

Student 3 Hebrew Name (if applicable)

Student 3 Nickname (if applicable)

Student 3 Secular School Name

Student 3 Grade in Religious School (2023-2024)

Will your student be doing a Trial Year?

Please Select OneYesNoARS Trial Year Option: For a new student in grades K, 1, 2, or 3, there is an option of the ARS Trial Year so that the family can get a sense of Temple Ohabei Shalom and see if it's right for them. The cost for this is $2350, and the Trial Year does not include any of the perks of synagogue membership like High Holy Day tickets. If the student comes back to ARS after the Trial Year, the family will join as members and pay dues at the Year 1 rate.

Student 3 Allergies or Medications

Please Select OneYesNo

Student 3 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an epi-pen?

Please Select OneYesNo

Student 3 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 3 Specific 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 your student has specific learning needs, please elaborate here.

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

Please Select OneYesNo

Please tell us anything we should know about learning supports that have helped your child in the past.

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Student 4 Information

Student 4 First Name

Student 4 Last Name

Student 4 Date of Birth

Student 4 Pronouns

Pronouns are important! Here's a helpful resource.

Other

Student 4 Hebrew Name (if applicable)

Student 4 Nickname (if applicable)

Student 4 Secular School Name

Student 4 Grade in Religious School (2023-2024)

Will your student be doing a Trial Year?

Please Select OneYesNoARS Trial Year Option: For a new student in grades K, 1, 2, or 3, there is an option of the ARS Trial Year so that the family can get a sense of Temple Ohabei Shalom and see if it's right for them. The cost for this is $2350, and the Trial Year does not include any of the perks of synagogue membership like High Holy Day tickets. If the student comes back to ARS after the Trial Year, the family will join as members and pay dues at the Year 1 rate.

Student 4 Allergies or Medications

Please Select OneYesNo

Student 4 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an epi-pen?

Please Select OneYesNo

Student 4 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 4 Specific 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 your student has specific learning needs, please elaborate here.

If your student has specific learning needs, please elaborate here.

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

Please Select OneYesNo

Please tell us anything we should know about learning supports that have helped your child in the past.

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Section C: 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 ARS students must be fully immunized according to CDC policies.) It is also TOS policy that all ARS students are fully vaccinated against COVID-19.

* Immunization Record

Section D: Volunteering at ARS

* Please check below if you would like to volunteer at ARS (check all that apply)

Please reach out to me for short-term volunteer opportunities throughout the yearOther (email Amy to tell her how you’d like to help!)Not at this time, but thank you for asking!

TOTAL

Thu, April 25 2024 17 Nisan 5784