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Mekor Shalom Religious School Registration 2022-23

Welcome to Mekor Shalom Religious School Registration
for the 2022-23 school year! 

Mekor Shalom is proud of the strong Jewish education the Religious School provides. Each student experiences Jewish learning in a safe, nurturing, meaningful, and engaging environment. 
Religious School Class Schedule:  
Sundays:  Grades K-7 meet at Mekor Shalom, 9:30 a.m. to 12:00 p.m.*
Wednesdays:  Grades 3-7 meet via Zoom, 5:00-6:30 p.m.

*As the pandemic continues, students will meet in person as long as it is safe to do so.  Mekor Shalom will follow all necessary COVID-19 protocols.  Masks will be required for in-person classes.

Please fill out this form, even if you have filled out a registration
form in prior years.

Student #1
Please indicate (e.g. She/Her/Hers, He/Him/His, They/Them/Theirs, a combination):
Once you have entered this information for each student enrolling, please continue on to the next section.

Student #2
Please indicate (e.g. She/Her/Hers, He/Him/His, They/Them/Theirs, a combination):

Student #3
Please indicate (e.g. She/Her/Hers, He/Him/His, They/Them/Theirs, a combination):

Student #4
Please indicate (e.g. She/Her/Hers, He/Him/His, They/Them/Theirs, a combination):

Adult #1:
Adult #2:

K-2nd grade students, $500/school year
3rd-7th grade students, $750/school year

Includes a book/supply fee and a snack fee (for the small drink and snack provided each week when classes are in person).
There is a $50 discount if you elect to pay the entire year's tuition in full by the start of the school year.  
There is also a $50 discount for the second and successive student(s) enrolled (the first student is still full price).

If you are making a tuition payment today (either whole or in part),
please enter the amount below.  If not, please leave it blank. Thank you.

I give permission to Congregation Mekor Shalom to photograph my child(ren) and use image(s) for publication purposes whether electronic, print, digital, or electronic publishing via the Internet.  Child(ren) will not be tagged in any images shared on official Mekor Shalom social media accounts. 

Medical Release:
I hereby give permission for my/our child(ren):
to participate in the programs at Mekor Shalom including off campus trips. In the event of an emergency, surgical or otherwise, and I cannot be reached, I hereby give permission for my child to be transported to the nearest medical facility and specifically authorize the representative of Congregation Mekor Shalom to select a physician and/or authorize medical treatment, including hospitalization, anesthesia, injection, surgery or other measures which he/she feels are in the best interest of my child.

Congregation Mekor Shalom is hereby released and held harmless from any claim, judgment, awards, settlements, or damages to any person or property arising directly or indirectly out of my child’s participation in the programs at Mekor Shalom, including off campus trips or the Congregation’s selection of physician, hospital, or any other medical service for my child in a medical emergency, or in connection with therein during of any such medical treatment.
By checking the “I Agree” checkbox, I agree and it is my intent to electronically sign and electronically submit this Authorization. I understand that by checking the “I agree” checkbox, I will be applying my electronic signature to this Authorization and that I will be bound with the same force and effect as if I had signed this Authorization on paper by hand.
So glad to have your child(ren) participating in Religious School at Mekor Shalom!

It is a privilege for Mekor Shalom to provide a safe, nurturing, and engaging educational
environment for each student who is enrolled in the program.

Thank you for the opportunity to teach your child(ren)!
Fri, July 12 2024 6 Tammuz 5784