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DBT Dharma School Registration 2025-26
Please register your child for the Dharma School year. If you have more than one child, please fill out form for each child (you may skip parent/guardian contact information if it is the same for your additional children).
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Student's Name *
Student's Email (if applicable)
Date of Birth *
MM
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DD
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YYYY
Grade for 2025-2026 *
Parent/Guardian Name
 *
Email Address
 *
(*write n/a if already filled out for multiple children)
Would you like to receive the weekly update emails? *
Phone Number *
(*write n/a if already filled out for multiple children)
Address  *
(*write n/a if already filled out for multiple children)
Parent/Guardian Birthday
MM
/
DD
/
YYYY
Second Parent/Guardian: Name
Second Parent/Guardian:  Email Address
Second Parent/Guardian: Would you like to receive the weekly update emails?
Clear selection
Second Parent/Guardian: Phone Number
Second Parent/Guardian: Address (if different)
Second Parent/Guardian: Birthday
MM
/
DD
/
YYYY
Emergency Contact (different than already listed persons) Name, relation, phone number *
Does your child have any food allergies, dietary preferences, health concerns or anything else you would like your teacher to know about?
*
Are you a current Temple Member?
Cash or Check (payable to DBT Dharma School)

If you would like to become a Temple member, please visit tsdbt.org or pick up a membership form in the lobby.
 *
Permission to post photos *
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