Request edit access
The Reform Temple of Rockland Religious School Registration
Before we know it, the 2025-2026 school year will be upon us!

-School for all students K'tanim-7th grade will begin on Sunday September 7th 2025.  
-K'tanim will meet the first Sunday of each month from 9:30-10:30am.
-Kindergarten-7th grade students will attend school on Sundays from 9-11:30am (please note the earlier start). 
-Tutoring for students in 3rd grade and above will be scheduled in the Fall.
- A schedule for Academy students will come out during the summer.  

Please complete the following registration form for your family.  Be sure to complete sections for all children that will be attending school, all parent information, emergency contacts and questions at the end.  

Thanks and have a great summer!
Sign in to Google to save your progress. Learn more
Email *
Is your family new to our school?

Fees information:
K'tanim monthly attendance is free.  
Tuition for grades Kindergarten-3 is free. Tuition for grades 4-7 is $360.00 
Tuition for Academy (grades 8-12) is free.  Temple membership is required once your oldest child reaches 3rd grade.
**Early Registration starts now!!!
Save $100.00 if you register by June 1, 2025.
 *
Required
Contact (Primary) - First and Last Name *
Contact's (Primary) Relationship to Student(s) *
Contact (Primary) - Phone Number *
Contact (Primary) -  Email  *
Contact (Primary) -Street Address *
Contact (Primary) -City *
Contact (Primary) -State *
Contact (Primary) -Zip Code *
Is there a Secondary Contact?
Please check one:
 *
Required
Contact (Secondary) - First and Last Name
Contact's (Secondary) - Relationship to Student(s)
Contact (Secondary) - Phone Number
Contact (Secondary) -  Email 
Contact (Secondary) - Street Address
Contact (Secondary) - City
Contact (Secondary) - State
Contact (Secondary) - Zip Code
How many students are being enrolled for the 2025-2026 school year? *
Required
Student #1 -First and Last Name *
Student #1 -Nickname (if preferred)
Student #1 -Hebrew Name *
Student #1 -Date of Birth *
Student #1 -Grade (for 2025-2026 school year) *
Required
Student #1 -Secular School *
Student #1 -IEP or 504?
Please note: a copy of the IEP or 504 plan should be given to the School Coordinator prior to 9/1/25.
 *
Required
Student #1 - Diagnosis (if any)
Student #1 - Allergies/Medical
Please describe allergies and medications with dosage and timing.
Student #2 -First and Last Name
Student #2 -Nickname (if preferred)
Student #2 -Hebrew Name
Student #2 -Date of Birth  
Student #2 -Grade (for 2025-2026 school year)
Student #2 -Secular School
Student #2 -IEP or 504?
Please note: a copy of the IEP or 504 plan should be given to the School Coordinator prior to 9/1/25.
Student #2 - Diagnosis (if any)
Student #2 - Allergies/Medical
Please describe allergies and medications with dosage and timing.
Student #3 -First and Last Name
Student #3 -Nickname (if preferred)
Student #3 -Hebrew Name
Student #3 -Date of Birth  
Student #3 -Grade (for 2025-2026 school year)
Student #3 -Secular School
Student #3 -IEP or 504?
Please note: a copy of the IEP or 504 plan should be given to the School Coordinator prior to 9/1/25.
Student #3 - Diagnosis (if any)
Student #3 - Allergies/Medical
Please describe allergies and medications with dosage and timing.
Student #4 -First and Last Name
Student #4 -Nickname (if preferred)
Student #4 -Hebrew Name
Student #4 -Date of Birth  
Student #4 -Grade (for 2025-2026 school year)
Student #4 -Secular School
Student #4 -IEP or 504?
Please note: a copy of the IEP or 504 plan should be given to the School Coordinator prior to 9/1/25.
Student #4 - Diagnosis (if any)
Student #4 - Allergies/Medical
Please describe allergies and medications with dosage and timing.
Emergency Contact First and Last Name *
Emergency Contact Relationship to Student/Students *
Emergency Contact Phone Number *
MEDICAL RELEASE FORM

By signing my name below, my child(ren) have permission to participate in the Religious School at The Reform Temple of Rockland. In consideration of my child(ren)'s acceptance as a religious school student, I hereby waive any and all claims against The Reform Temple of Rockland, 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 School Coordinator, or person designated by the , 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 New York. 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. 

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

From time to time your child’s photo may be taken in our classrooms or special events.  We use these photos in the synagogue newsletters, on our synagogue website as well as our Facebook groups and other publicity materials.

Please select one:
 *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms