Our Tent Registration 2021-2022

Welcome

Welcome

IF YOU ARE A MEMBER, PLEASE LOGIN.

This will insure proper credit to your account. Login at the top right corner. If you are accessing this form through your phone, click the 3 line menu at the top right corner.

ATTENTION MAC USERS! PLEASE USE CHROME OR FIREFOX BROWSER AS SAFARI PRODUCES ERRORS.

IF YOU HAVE ANY DIFFICULTY REGISTERING, PLEASE CONTACT CHARLOTTE VERSAGI (cversagi@suburbantemple.org) VIA EMAIL. THANK YOU!

IF YOU ARE IN 8TH - 12TH GRADE YOU SHOULD SIGN UP FOR CLASS ONE LEARNING SESSION AND TO BE A MADRICH/A FOR THE OTHER LEARNING SESSION
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PHOTO RELEASE

Photo Release

Yes, I give my permission to use my or my family's pictures or likenessesNo, I do not give permission to use my or my family's pictures or likenesses.Photos may be used in the Suburban Temple-Kol Ami newsletter, website, Facebook pages, other social media, and in local newspapers. My permission shall remain in effect unless revoked by me and communicated to Suburban Temple-Kol Ami in writing.

LEARNER INFORMATION

* Describe your family.

Household Address

Household City

* Household Zip Code

LEARNER ENROLLMENT

Learner # 1

Learner #1 First Name

Learner #1 Last Name

Email for Learner # 1

Learner # 1 Phone (Mobile Preferred)

Learner # 1 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 1 Grade (12th Grade or below)

* Session 1 Learner # 1

* Session 2 Learner # 1

For this trimester I would like to learn...

Learner # 2

Learner #2 First Name

Learner #2 Last Name

Learner #2 Email

Learner # 2 Phone (Mobile Preferred)

Learner # 2 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 2 Grade (12th Grade or below)

* Session 1 Learner # 2

* Session 2 Learner # 2

For this trimester I would like to learn...

Learner # 3

Learner # 3 First Name

Learner # 3 Last Name

Learner #3 Email

Learner # 3 Phone (Mobile Preferred)

Date of Birth Learner # 3 (12th Grade or below)

mm/dd/yyyy

Learner # 3 Grade (12th Grade or below)

* Session 1 Learner # 3

* Session 2 Learner # 3

For this trimester I would like to learn...

Learner # 4

Learner # 4 First Name

Learner #4 Last Name

Learner # 4 Email

Learner # 4 Phone (Mobile Preferred)

Learner # 4 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 4 Grade (12th Grade or below)

* Session 1 Learner # 4

* Session 2 Learner # 4

For this trimester I would like to learn...

Learner # 5

Learner #5 First Name

Learner #5 Last Name

Learner #5 Email

Learner # 5 Phone (Mobile Preferred)

Learner # 5 Date of Birth (12th Grade or below)

mm/dd/yyyy

Learner # 5 Grade (12th Grade or below)

* Session 1 Learner # 5

* Session 2 Learner # 5

For this trimester I would like to learn...

LEARNER'S MEDICAL AND CONFIDENTIAL INFORMATION FORM

ALL (including adults) learners must complete this form.

** CLICK HERE FOR MANDATORY MEDICAL/CONFIDENTIAL FORM **

COME BACK TO CLICK ON THE LINK ABOVE AFTER YOU COMPLETE ENROLLMENT.

DONATE TO OUR TENT!

MAKE A DONATION!!! SPONSOR OUR TENT!!!

For $360 you can sponsor 1 full class for a trimester.
For $72 you can sponsor a single class.
You can also do a Tribute in Honor of a Teacher!

Our Tent Class $360Single Class $72

Other

Donate any amount. Enter with no $.

Type any dedication, teacher appreciation or note here.

LEARNER'S TUITION

Tuition is required for each learner under the age of 18 and all non-member learners. Adult learners who are members of ST-KA are encouraged to make gifts of support to Our Tent but do not pay tuition.

Please indicate the number of learners in each category in the boxes below.

Member (Kindergarten-12th grade)

ST-KA Adult Learner

Non-Member

Total

If you have not already done so, don't forget to click link for Learner medical form after you submit registration. Your registration is not complete unless the Medical Information form is completed.

https://www.suburbantemple.org/form/our-tent-Learner-medical-information-.html

Fri, January 21 2022 19 Sh'vat 5782