Eitzim 5785 Registration

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Congregation Albert members save money on their child(ren)'s religious school tuition. Each student is $390 for members, and $600 for non-members. A staff member will contact you for payment details.

If you are interested in becoming a member to receive reduced rates, get free High Holy Days seats, and more, please click here to complete a membership application. You will receive notice of your member acceptance no later the the second week of the following month. Please reach out to Daniele Williams at ed@congregationalbert.org for any questions or concerns regarding membership.

* Child 1 First Name

* Child 1 Last Name

Child 1 Hebrew Name

* Date of Birth. Please type date in this format:

* What grade level will this child be in as of 09/2024?

Gender

What is your child's preferred gender description?

What are your child's preferred pronouns?

Please list any allergies, conditions, or medications staff should be aware of for your child's health and safety.

If your child has an I.E.P., please email it to chrissy@congregationalbert.org with the subject line "Eitzim IEP"

Are you enrolling more children?

Child 2 First Name

Child 2 Last Name

Child 2 Hebrew Name

Date of Birth. Please type date in this format: (MM/DD/YYYY):

What grade level will this child be in as of 09/2024?

Gender

Please list any allergies, conditions, or medications staff should be aware of for your child's health and safety.

If your child has an I.E.P., please email it to chrissy@congregationalbert.org with the subject line "Eitzim IEP"

Are you enrolling more children?

Child 3 First Name

Child 3 Last Name

Child 3 Hebrew Name

Child 3 Date of Birth

What grade level will this child be in as of 09/2024?

Gender

Please list any allergies, conditions, or medications staff should be aware of for your child's health and safety.

If your child has an I.E.P., please email it to chrissy@congregationalbert.org with the subject line "Eitzim IEP"

Are you enrolling more children?

Child 4 First Name

Child 4 Last Name

Child 4 Hebrew Name

Child 4 Date of Birth

What grade level will this child be in as of 09/2024?

Gender

Please list any allergies, conditions, or medications staff should be aware of for your child's health and safety.

If your child has an I.E.P., please email it to chrissy@congregationalbert.org with the subject line "Eitzim IEP"

Caretaker / Guardian 1 First Name

Caretaker / Guardian 1 Last Name

Caretaker / Guardian 1 Hebrew Name

* Mailing Address

Address Line 2 (optional)

* City

* State

* ZIP Code

Phone Number

Caretaker / Guardian 1 Cell Phone Number

* Email Address

In which religious tradition were you raised?

* Which of these best describes you?

Spouse's First Name

Spouse's Last Name

Spouse's Hebrew Name

Spouse's Date of Birth. Please type date in this format:

When were you married? Please type date in this format:

Is your spouse also Jewish?

Spouse's Gender

What is your spouse's preferred gender description?

What are your spouse's preferred pronouns?

Partner First Name

Partner Last Name

Partner's Hebrew Name

Partner's Date of Birth. Please type date in this format:

Is your partner also Jewish?

* Partner's Gender

What is your partner's preferred gender description?

What are your partner's preferred pronouns?

Please list up to 3 emergency contacts in the event we cannot get ahold of you. Provide first name, last name, relationship to the child(ren), a good phone number, and if they are authorized to pick up the child(ren). We will ALWAYS make every attempt to contact caregivers before reaching out to emergency contacts.

I give permission for my child(ren) to receive:

Emergency Medical TreatmentEmergency Medical TransportationBasic first aid (on or off-site)

I confirm that my child(ren) is/are up to date on immunizations per the New Mexico state requirements (immunization records may be requested). Enter your initials to confirm.

Photos, videos, and testimonials from your child(ren)'s participation can be used in community and congregational media or publications. Enter your initials if you DO NOT want your child(ren) included.

Are you and your family Congregation Albert Members?

* Please check this box after reading our Code of Ethics.

Please check this box after reading our Code of Ethics.Click here to read our Code of Ethics.

Mon, October 14 2024 12 Tishrei 5785