Dor Hadash Religious School • Student Registration • 2021-22/5782
Please complete the registration form by August 8. Classes begin on Wednesday, Sept. 1
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Email *
Family Name *
Please use the name you would like listed in our school directory
Can we include your information in our school directory? *
This will be distributed to school families only
Required
Please fill out the following information:
If you are a returning family, and your information is the same, you do not need to fill in those sections. We would like to confirm emergency numbers and emails, so please complete those portions.
Parent  #1 *
Name
Phone Numbers (Please indicate which type for purposes of sending text messages.)
Can we send you text messages *
Email *
Home Address
This is only needed if you are a new family, or have a new address this year. Please include city and zip code
Parent #2
Phone Numbers (Please indicate which type for purposes of sending text messages)
Can we send you text messages?
Clear selection
Email
Home Address
If different from Parent  1
Child #1 *
Name
Hebrew Name
Grade and School (include School District) *
Birthdate *
Please fill out the information below for Child #2
Name
Hebrew Name
Grade and School (Include School District)
Birthdate
Please fill out the information below for Child #3
Name
Hebrew Name
Grade and School (Include School District)
Birthdate
If we have to get in touch with you in the event of an emergency, please list your family's most reachable phone numbers. *
Emergency Contact *
Name & Relationship (other than parent)
Phone *
Emergency Contact #2
Name & Relationship (other than parent)
Phone
You are almost done!
Here's a link to our student information and release forms. For returning students, please indicate if there is any new information. You can email new information, or fill out a new form. All forms should be returned via email. For new students: please print this form for EACH child and complete one copy per child in your family.   https://docs.google.com/document/d/1ZrN7b-wdx5L1CfahVuuEMOnUHuxJvJEWpJiT15WmGKY/edit?usp=sharing

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