North Williamsburg

After School Hebrew & Jewish Culture Class

Wednesdays, Oct 9th till Dec 18th
5pm-6pm
No class on Nov 27th
$350 for 10 sessions

$350.00

After School Hebrew & Jewish Culture Class Application

Name(Required)

First Last

Date of Birth(Required)

Gender(Required)

Male

Female

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent/ Guardian Name (1)(Required)

First Last

Occupation(Required)

Cell Phone Number(Required)

Emergency Contact 1(Required)

First Last Relationship

Emergency Contact 2(Required)

First Last Relationship

Allergies or medical conditions:

Release(Required)

I hereby give my permission for my child to participate in all programs, activities and trips. I understand and fully recognize that risks are involved and I hereby release the JCC Brooklyn - North Williamsburg/a project of the Kings Bay Y or any of its sponsors, benefactors, or employees from any liability arising out of any injury to my child in the event of a medical emergency or surgical emergency. I do hereby give authority to the program and staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. I grant permission to the physician designated by the JCC Brooklyn - North Williamsburg/a project of the Kings Bay Y to hospitalize, secure proper treatment for, and order injections, anesthesia or surgery for my child. Furthermore, I understand that payment for medical services is solely the family’s responsibility. I hereby give permission to the JCC Brooklyn/Kings Bay YM-YWHA, Inc. to take photographs of me and/or my child to be shown in a video, brochure, advertisement, or internet display for purposes of promoting interest in the JCC Brooklyn/a project of the Kings Bay Y. I release the JCC Brooklyn/ Kings Bay YM-YWHA, Inc. from any claims resulting from the pictures taken on, before, or after the date of this communication. I do hereby give permission for my child to participate in all activities, including off-ground activities. I authorize the JCC Brooklyn/Kings Bay YM-YWHA, Inc. to act as a parent surrogate on my behalf. I realize that itineraries and/or programs are subject to change prior to, and during, the year.

Signature(Required)

Terms Of Enrollment:(Required)

The JCC Brooklyn - North Williamsburg/a project of the Kings Bay Y will not be responsible for damage to, or loss of, personal property. It is the goal of our program to provide a healthy and safe environment for all participants. If a participant displays any inappropriate behavior, or endangers the health and safety of participants or staff, we may suspend the participant from the program or consider permanent termination in extreme situations.

A service charge of $125 will be applied for any refunds or cancellations.

Signature(Required)

Date(Required)

Hebrew Class Questionnaire

Please make sure to fill out all fields and answer as thoroughly as possible to help us best plan to accommodate the learning needs of all students

1. Is your child a native Hebrew speaker?(Required)
Yes
No

If not, what language(s) does your child speak?

2. What are you hoping to accomplish by enrolling your child in this program? Any specific goals? Ex. Learn the entire Alef Bet, colors in Hebrew etc.(Required)

3. What styles of learning does your child seem most responsive to? Ex: learns best when physically active(Required)

4. Tell us a little about your child’s personality. Ex: Are they shy, or extroverted? Do they have any sensory sensitivities? Any intellectual or behavioral differences we should be aware of?(Required)

Quantity

After School Hebrew & Jewish Culture Class quantity

Category: Uncategorized

Description

Wednesdays, Oct 9th till Dec 18th
5pm-6pm
No class on Nov 27th
$350 for 10 sessions

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North Williamsburg

After School Hebrew & Jewish Culture Class

After School Hebrew & Jewish Culture Class

After School Hebrew & Jewish Culture Class Application