The Jewish Experience Returning Student Registration Form
2019 – 2020 / 5780
We are thrilled that your child will be returning to the Jewish Experience for the 2019-2020 school year.
Thank you for taking the time to complete this form for each child who will attend Jewish Experience classes. Contact Rabbi Elliot Skiddell at educator@centralsy.org or 516-766-6418 with any questions or concerns.

Book, Materials and Special Events Fee Information 2019-2020:
CSBE Members: $180 for the first child, $100 each additional child. [$480 maximum per family] Non members: $360 per child [maximum $500 per family]
CSBE MEMBERSHIP IS REQUIRED ONCE THE OLDEST CHILD IN THE FAMILY BEGINS THIRD GRADE
All checks should be made payable to Central Synagogue - Beth Emeth and mailed to 430 DeMott Avenue, Rockville Centre.

Please note that a medical treatment authorization form must be filled out each year. Forms should be completed at https://forms.gle/1bU6nVNRZyUqNrncA.
Child's Name (First and Last) *
Grade in September 2019 *
Please Note: Membership in CSBE is required when the oldest child in the family begins Third Grade.
Please check the box below that best describes your current affiliation with CSBE. *
Required
Please contact me regarding membership information.
Has any of the following information changed since last year? *
Required
Please include corrected or updated information in this space.
I would like to volunteer for:
Please understand that if you do not volunteer, you may be assigned a duty.
Please print your name below if you do not want photos of your child published on Central Synagogue - Beth Emeth websites, in newspapers, other media or social networking sites. (Note: Students will not be identified individually in any photos.)
I understand that my child may be using the Internet during the school year and must demonstrate responsible behavior when using the Internet. (Please type yes and your child's name in the box below.) *
Parent/ Guardian Signature *
Parent/ Guardian Signature
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