Temple Emaunu-El - Emanu-El Explorers

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Join the fun, meet other families and get a view into the
Temple Emanu-El Religious School!

Once a month, from October to April, your children will join in our school’s vibrant learning experiences. Drop them off on Sunday mornings (9:30 a.m.-12 p.m.) or Monday afternoons (4-6 p.m.) and join them for select activities and holiday celebrations.

Emanu-El Explorers is led by veteran Religious School teachers Diane Bialick, Jessica Hasicka, and Emily Opper, along with Cantor Mo Glazman, Saul Kaiserman (Director of Lifelong Learning), and Jackie Schreiber (Director of Faculty and Family Engagement). Emanu-El Explorers includes 7 interactive and fun-filled sessions; please visit emanuelnyc.org/explorers for the complete schedule.

$360 for members
$500 for nonmembers; credit of $140 on membership if you join the temple during the year
Includes complimentary tickets to all open-seating High Holiday services,including Young Family and Family Worship.
Also includes a video yearbook and a subscription to PJLibrary!

The Sunday morning session of Explorers has sold-out. To place your child on a wait-list, please contact us at (212) 507-9546 or school@emanuelnyc.org. Spaces are still available for Monday afternoons. Emanu-El members may also register for the weekly Religious School program at www.emanuelnyc.org/RSForms.

Emanu-El Explorers - Sunday

Qty

Description

Amount

Total

Sunday - Members Sold Out

$360.00

---

Sunday - Nonmembers Sold Out

$500.00

---

credit of $140 on membership if you join the temple during the year

Emanu-El Explorers - Monday

Qty

Description

Amount

Total

Monday - Members

$360.00

---

Monday - Nonmembers

$500.00

---

credit of $140 on membership if you join the temple during the year

Total: $0.00

STUDENT INFORMATION

Student #1

Name of student: *

Nickname:

This child will be attending Explorers on - only one box may be checked

Sundays at 9:30 AM – 12:00 PM

Mondays at 4:00 PM – 6:00 PM

Gender: *

Date of birth: *

School grade of student: *

Current school or program: *

Does this student have any special needs, learning issues, or an IEP?

Special needs? *

We would like to discuss with you, in person, the special needs for this child. What date/time may we call you to discuss?

If Yes to special needs, provide date & time to contact:

MEDICAL INFORMATION

Please remember to inform the Religious School office if there are changes in the student’s health over the course of the year. All medical information is kept strictly confidential.

Please describe any allergies or special medical conditions: *

Is your child regularly on any medication? *

If Yes, please describe:

School personnel are not permitted to administer medication to students; if your child will require the above medication during Religious School hours, please detail the method by which your child receive this medication.

Please detail the method by which your child receive this medication: *

A separate Allergy Information & Epi Pen Authorization Form will be sent to all families with a child who carries an epi pen.

Does your child carry an epi pen? *

In the unlikely event of an emergency, please provide the contact info of your child’s physician

Name: *

Phone: *

In the event that no one can be reached, I give my permission for the staff of Congregation Emanu-El to take whatever emergency steps are necessary.

I give my permission: *

ADULT INFORMATION

Adult #1

Name of registering adult (must be legal parent or guardian): *

Address: *

(street, city, state, zip)

Home Phone: *

Work Phone: *

Cell Phone: *

Email: *

Relation to child(ren): *

Are you a member of Temple of Emanu-El? *

Religion of Parent:

Emergency Contact

If Adult 1 or 2 cannot be reached, please provide the following contact for emergency purposes.

Name: *

Relationship: *

Address: *

(street, city, state, zip)

Home Phone: *

Work Phone: *

Cell Phone: *

Email: *

DISMISSAL

In addition to the adults already listed, I authorize the following adult to pick up my child(ren) from this program.

Name:

Phone Number:

Mobile Phone Number:

Email:

Relationship:

ADDITIONAL INFORMATION

Please tell us how you heard about Emanu-El Explorers: *

Congregation Emanu-El reserves the right to photograph and video the children participating in Emanu-El Explorers for use in public promotion or public education of this program. It is our policy to not identify any students by name in Temple publicity. If you have questions or concerns about this policy, contact the Religious School at 212-507-9546 or school@emanuelnyc.org.

This program includes an automatic subscription to PJLibrary. If you do not wish to "sign up" for PJLibrary please contact the Religious School at 212-507-9546 or school@emanuelnyc.org upon enrollment in Emanu-El Explorers.

Why did you decide to register for Explorers this year?

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *