Congregation Tifereth Israel Hebrew School Registration Form
Contact: Lisa Aamodt morahlisaa@gmail.com 516-676-5080
Student's Full Name
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Student's Hebrew Name
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Gender
Birthday
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Grade
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School
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Address
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City State
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Zip
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Home Phone
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Email
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Parent 1
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Parent Contact Number
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Parent 2
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Parent Contact Number
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Allergies
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Epipen
If I am not available and a medical emergency arises, the supervising teacher has my permission to seek medical help with
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Emergency Contact 1
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Emergency Contact 2
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I give permission for photos to be taken of my child and used by the synagogue.
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Would you like to receive text messages regarding the program?
Is there anything else you would like us to know about your child?
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