TAI School Enrollment Form 2016

Parent/Guardian 1 Information















Parent/Guardian 2 Information
















Child 1 Information




PJ Playgroup
PJ Playgroup is a special Jewish experience for children aged three and under and their parents. It is designed to bring children and parents together in a cooperative Jewish learning environment. Storytelling, singing, hands-on activities form the core of our program. This is a joint program with Federation, OZS, and Temple Adath Israel. The location changes monthly between TAI, OZS and an outside location. There is no fee for this program.

The class meets from 10:15 to 11:30 AM nine times a year.

Please contact pjlibrary@jewishlexington.org for the monthly email location announcement.
A PJ Playgroup schedule can also be found on the TAI  website under "Learning"

Emergency/Medical Information
Emergency Contacts
Emergency contact information: Please list name, relationship, and phone number for three people we may contact in the event of an emergency when you cannot be reached.


















Student Profile








Field Trip and Media Permissions

By submitting this enrollment, I, the parent/guardian of the minor child,


1) Hereby give permission for the minor child to attend any field trip sponsored by Temple Adath Israel Religious School. I hereby do release and hold harmless Temple Adath Israel and its trustees, agents, officers, servants, and employees against loss (including reasonable attorney’s fees) from any and all claims, or causes of action of any kind or nature that may be brought by  or on behalf of the said minor child or by me arising out of any and all known or unknown, foreseen and unforeseen bodily or personal injuries, damages to property and consequences thereof which may be sustained by the minor or by me arising out of or in connection with the minor child’s participation in this field trip, except such liability or claim of liability as may result from gross negligence on the part of Temple Adath Israel.

2) Hereby give permission if the minor child should suffer an injury or illness during the trip, I authorize the employees of Temple Adath Israel to use their discretion to transport or to have the minor child transported to
any medical facility and hereby give consent in my absence to have the minor child treated at any
medical facility, and I take full responsibility for that action.


3) Hereby give permission to have my child's photo in all temple publications including electronic, private and public.


If I do not give permission for field trips, emergency transportation and/or photo use , I will contact the religious school office via email to make my request: religioused@lextai.org

Child 2 Information




PJ Playgroup
PJ Playgroup is a special Jewish experience for children aged three and under and their parents. It is designed to bring children and parents together in a cooperative Jewish learning environment. Storytelling, singing, hands-on activities form the core of our program. This is a joint program with Federation, OZS, and Temple Adath Israel. The location changes monthly between TAI, OZS and an outside location. There is no fee for this program.

The class meets from 10:15 to 11:30 AM nine times a year.

Please contact pjlibrary@jewishlexington.org for the monthly email location announcement.
A PJ Playgroup schedule can also be found on the TAI  website under "Learning"
Emergency/Medical Information
Emergency Contacts
Emergency contact information: Please list name, relationship, and phone number for three people we may contact in the event of an emergency when you cannot be reached.


















Student Profile








Field Trip and Media Permissions

By submitting this enrollment, I, the parent/guardian of the minor child,


1) Hereby give permission for the minor child to attend any field trip sponsored by Temple Adath Israel Religious School. I hereby do release and hold harmless Temple Adath Israel and its trustees, agents, officers, servants, and employees against loss (including reasonable attorney’s fees) from any and all claims, or causes of action of any kind or nature that may be brought by  or on behalf of the said minor child or by me arising out of any and all known or unknown, foreseen and unforeseen bodily or personal injuries, damages to property and consequences thereof which may be sustained by the minor or by me arising out of or in connection with the minor child’s participation in this field trip, except such liability or claim of liability as may result from gross negligence on the part of Temple Adath Israel.

2) Hereby give permission if the minor child should suffer an injury or illness during the trip, I authorize the employees of Temple Adath Israel to use their discretion to transport or to have the minor child transported to
any medical facility and hereby give consent in my absence to have the minor child treated at any
medical facility, and I take full responsibility for that action.


3) Hereby give permission to have my child's photo in all temple publications including electronic, private and public.


If I do not give permission for field trips, emergency transportation and/or photo use , I will contact the religious school office via email to make my request: religioused@lextai.org

Child 3 Information




PJ Playgroup

Emergency/Medical Information
Emergency Contacts
Emergency contact information: Please list name, relationship, and phone number for three people we may contact in the event of an emergency when you cannot be reached.


















Student Profile








Field Trip and Media Permissions

By submitting this enrollment, I, the parent/guardian of the minor child,


1) Hereby give permission for the minor child to attend any field trip sponsored by Temple Adath Israel Religious School. I hereby do release and hold harmless Temple Adath Israel and its trustees, agents, officers, servants, and employees against loss (including reasonable attorney’s fees) from any and all claims, or causes of action of any kind or nature that may be brought by  or on behalf of the said minor child or by me arising out of any and all known or unknown, foreseen and unforeseen bodily or personal injuries, damages to property and consequences thereof which may be sustained by the minor or by me arising out of or in connection with the minor child’s participation in this field trip, except such liability or claim of liability as may result from gross negligence on the part of Temple Adath Israel.

2) Hereby give permission if the minor child should suffer an injury or illness during the trip, I authorize the employees of Temple Adath Israel to use their discretion to transport or to have the minor child transported to
any medical facility and hereby give consent in my absence to have the minor child treated at any
medical facility, and I take full responsibility for that action.


3) Hereby give permission to have my child's photo in all temple publications including electronic, private and public.


If I do not give permission for field trips, emergency transportation and/or photo use , I will contact the religious school office via email to make my request: religioused@lextai.org

Child 4 Information




PJ Playgroup
PJ Playgroup is a special Jewish experience for children aged three and under and their parents. It is designed to bring children and parents together in a cooperative Jewish learning environment. Storytelling, singing, hands-on activities form the core of our program. This is a joint program with Federation, OZS, and Temple Adath Israel. The location changes monthly between TAI, OZS and an outside location. There is no fee for this program.

The class meets from 10:15 to 11:30 AM nine times a year.

Please contact pjlibrary@jewishlexington.org for the monthly email location announcement.
A PJ Playgroup schedule can also be found on the TAI  website under "Learning"
Emergency/Medical Information
Emergency Contacts
Emergency contact information: Please list name, relationship, and phone number for three people we may contact in the event of an emergency when you cannot be reached.


















Student Profile








Field Trip and Media Permissions

By submitting this enrollment, I, the parent/guardian of the minor child,


1) Hereby give permission for the minor child to attend any field trip sponsored by Temple Adath Israel Religious School. I hereby do release and hold harmless Temple Adath Israel and its trustees, agents, officers, servants, and employees against loss (including reasonable attorney’s fees) from any and all claims, or causes of action of any kind or nature that may be brought by  or on behalf of the said minor child or by me arising out of any and all known or unknown, foreseen and unforeseen bodily or personal injuries, damages to property and consequences thereof which may be sustained by the minor or by me arising out of or in connection with the minor child’s participation in this field trip, except such liability or claim of liability as may result from gross negligence on the part of Temple Adath Israel.

2) Hereby give permission if the minor child should suffer an injury or illness during the trip, I authorize the employees of Temple Adath Israel to use their discretion to transport or to have the minor child transported to
any medical facility and hereby give consent in my absence to have the minor child treated at any
medical facility, and I take full responsibility for that action.


3) Hereby give permission to have my child's photo in all temple publications including electronic, private and public.


If I do not give permission for field trips, emergency transportation and/or photo use , I will contact the religious school office via email to make my request: religioused@lextai.org

Fees and Payment Options
FEES:
Registration & Book/Supply Fee: $395.00 (per child)



$

Credit Card Information










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