ARS Registration 2020-2021

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Thank you for enrolling your student in Ansin Religious School (ARS) for 2020-2021! Please note that you must be a member in good standing of Temple Ohabei Shalom to attend ARS (unless your student is in grades K-3 and you are doing our special Trial Year option). ARS costs are $1425 per student this year; there are no costs/payments associated with this form. Upon receipt, our staff will add the appropriate charge to your account and issue you a payment invoice.

More ARS tuition information can be found here.
Registration for grades 8-12 can be found here (the form below is only for PreK - 7 grade).
Please email ars@ohabei.org with any questions. Thank you!

* Is your family new to our school?

Please Select OneYesNo

Welcome! We are so happy to have you! Please also fill out this New Member Form. If you have any questions, please email Amy Deutsch.

https://www.ohabei.org/form/new-member-form

What can we do to support you as a new family?

Section A: Family Contact Information

* First Name (Primary)

* Last Name (Primary)

* Email (Primary)

* Phone (Primary)

* Relationship to Student(s) (Primary)

* Street Address (Primary)

Street Address Line 2 (Primary)

* City (Primary)

* State (Primary)

* ZIP (Primary)

* Is there a secondary contact?

Please Select OneYes, at the same address as the primary contact.Yes, but at a different address than the primary contact.NoIf there is a secondary contact, all emails and mailings will go to both contacts. In case of urgent need, the primary contact will be notified first.

First Name (Secondary)

Last Name (Secondary)

Email (Secondary)

Phone (Secondary)

Relationship to Student(s) (Secondary)

Street Address (Secondary)

Street Address Line 2 (Secondary)

City (Secondary)

State (Secondary)

ZIP (Secondary)

* Emergency Contact 1 Name

* Emergency Contact 1 Phone

* Emergency Contact 1 Relationship

* Emergency Contact 2 Name

* Emergency Contact 2 Phone Number

* Emergency Contact 2 Relationship

Section B: Student Enrollment Information

* How many students (PreK – 7th grade) are being enrolled for the 2020-2021 year?

Please Select One1 Student2 Students3 Students4 Students

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

Student 1 Hebrew Name (if applicable)

Student 1 Nickname (if applicable)

* Student 1 Grade in Religious School

Will your student be doing a Trial Year?

Please Select OneYesNoK-3 only: First year ARS only trial membership (no membership fees paid) is available for additional charge ($750, non-member fee). If the student re-enrolls, the family must join and pays dues at the “Year 1” rate.

* Student 1 Secular School Name

Student 1 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 1 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 1 Special Learning Needs

Please Select OneYes (IEP, 504 plan, ICAP)NoMy student does not have an IEP but needs specific learning supports.

Student 1 Special Learning Needs

If yes, please elaborate here and send your plan to Amy Deutsch at adeutsch@ohabei.org.

* Medical Insurance Company

* Insurance Policy Number

* Student 1 Allergies or Medications

Please Select OneYesNoDoes your student have allergies or medications we need to know about?

Student 1 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an epi-pen?

Please Select OneYesNo

Student 1 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

* Student's Doctor's Name

* Doctor's Phone Number

Student's Dentist's Name

Dentist's Phone Number

Date of Most Recent Tetanus Booster

* If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Please feel free to tell us any other information that may help us to create the best environment for your student (talents you wish us to nurture; special family situations including joint custody, intermarriage; learning disabilities; health problems...)

Student 2 Information

Student 2 First Name

Student 2 Last Name

Student 2 Birthdate

Student 2 Hebrew Name (if applicable)

Student 2 Nickname (if applicable)

Student 2 Grade in Religious School

Will your student be doing a Trial Year?

Student 2 Secular School Name

Student 2 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 2 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

Student 2 Special Learning Needs

Please Select OneYes (IEP, 504 plan, ICAP)NoMy student does not have an IEP but needs specific learning supports.

Student 2 Special Learning Needs

If yes, please elaborate here and send your plan to Amy Deutsch at adeutsch@ohabei.org.

Medical Insurance Company

Insurance Policy Number

Student 2 Allergies or Medications

Please Select OneYesNoDoes your child have allergies or medications we need to know about?

Student 2 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an epi-pen?

Please Select OneYesNo

Student 2 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

Student's Doctor's Name

Doctor's Phone Number

Student's Dentist's Name

Dentist's Phone Number

Date of Most Recent Tetanus Booster

If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Student 3 Information

Student 3 First Name

Student 3 Last Name

Student 3 Birthdate

Student 3 Hebrew Name (if applicable)

Student 3 Nickname (if applicable)

Student 3 Grade in Religious School

Will your student be doing a Trial Year?

Student 3 Secular School Name

Student 3 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 3 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

Student 3 Special Learning Needs

Please Select OneYes (IEP, 504 plan, ICAP)NoMy student does not have an IEP but needs specific learning supports.

Student 3 Special Learning Needs

If yes, please elaborate here and send your plan to Amy Deutsch at adeutsch@ohabei.org.

Medical Insurance Company

Insurance Policy Number

Student 3 Allergies or Medications

Please Select OneYesNoDoes your child have allergies or medications we need to know about?

Student 3 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an epi-pen?

Please Select OneYesNo

Student 3 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

Student's Doctor's Name

Doctor's Phone Number

Student's Dentist's Name

Dentist's Phone Number

Date of Most Recent Tetanus Booster

If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Student 4 Information

Student 4 First Name

Student 4 Last Name

Student 4 Birthdate

Student 4 Hebrew Name (if applicable)

Student 4 Nickname (if applicable)

Student 4 Grade in Religious School

Will your student be doing a Trial Year?

Student 4 Secular School Name

Student 4 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 4 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

Student 4 Special Learning Needs

Please Select OneYes (IEP, 504 plan, ICAP)NoMy student does not have an IEP but needs specific learning supports.

Student 4 Special Learning Needs

If yes, please elaborate here and send your plan to Amy Deutsch at adeutsch@ohabei.org.

Medical Insurance Company

Insurance Policy Number

Student 4 Allergies or Medications

Please Select OneYesNoDoes your child have allergies or medications we need to know about?

Student 4 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Has your student been prescribed an epi-pen?

Please Select OneYesNo

Student 4 Allergy/Medication Details

If yes, we MUST have a non-expired Epi-Pen with the pharmacy label in our office! Please specify here for which allergen the Epi-Pen was prescribed.

Student's Doctor's Name

Doctor's Phone Number

Student's Dentist's Name

Dentist's Phone Number

Date of Most Recent Tetanus Booster

If necessary, can we administer Tylenol or Motrin to your student?

Please Select OneYesNo

Have there been any recent changes or transitions in your student's life? (For example: a move, a new school, parent separation, death, social situations at school, etc.)

Section C: Release Forms

Medical Release

This health history is correct as far as I know. The person(s) herein described has my permission to engage in all prescribed activities except as noted above. I release Ohabei Shalom and its staff from all responsibilities other than classes, programs, and supervised and scheduled activities. In the event that I cannot be reached in an emergency, I hereby authorize the physician selected by the Ohabei Shalom Religious School Directors to hospitalize, secure proper treatment for and order injections, anesthesia, or surgery for my child named above.

* Medical Release: Enter your name below

By typing my name, I confirm I have read, understand and agree to the above.

Photo/Media Release

The Ansin Religious School of Temple Ohabei Shalom may use any individual or group photographs, written comments, video and/or audio recordings, taken at Temple Ohabei Shalom or elsewhere, documenting student in-school or out of school activities, for the purpose of promoting student enrollment and/or advertising the school, including, without limitation, on the Temple Ohabei Shalom website. TOS Staff is aware of the legal, moral, and ethical issues surrounding images of students in the public domain and will comply with all necessary guidelines.

* Photo/Media Release: Enter your name below

By typing my name, I confirm I have read, understand and agree to the above. If you do not grant permission for your student's image to be used, please email Amy Deutsch.

Universal Permission Slip

My student(s) has my permission to participate in field trips and youth group events planned by the Ansin Religious School of Ohabei Shalom during the 2020-2021 academic year. I understand that all trips will be adequately supervised and that transportation will either be by parental carpools, school buses, the MBTA or walking and that I will be informed beforehand of all such trips.

* Universal Permission Slip: Enter your name below

By typing my name, I confirm I have read, understand and agree to the above.

Immunization Record

* Is your student up to date with their immunizations in accordance with Massachusetts requirements?

YesMy student is immunocompromised and cannot therefore follow the state's immunization schedule. I will provide a doctor's note.

https://www.mass.gov/info-details/school-immunizations

Section D: Congregation Community

You may have noticed that at the top of the form we begin with family information. This is intentional. The work of raising and educating Jewish children cannot be done in the school alone, but is a project of the school, the family and the community. You are not just registering your child(ren) for school today, but in fact your entire family. When you come in the building and spend time learning and volunteering with us, you make a powerful statement to your children that Jewish learning is a lifelong process and that we are all on the same team in creating these experiences for them. Don’t underestimate the subtle power of this statement!

We have several days during the course of the year (see calendar for dates) on which parents can participate in programs with students inside and outside of the Temple. Please plan to join us on these days.

In addition to those opportunities to participate we are in need of regular volunteers to make our school work. Would you consider supporting our school in an ongoing role or a limited engagement?

Ongoing Opportunities (check all that apply)

Room ParentSubstitute TeachingARS Parent Task ForceKayla's Caring Community

Limited Engagements (check all that apply)

Volunteer at Shabbat B'yachad(s)Volunteer at the MOSTY/BOSTY Shul In (for parents with students NOT at the Shul In, i.e. grades 2 and below)Volunteer at the TOSTY Shul In (for parents with students NOT at the Shul In, i.e. grades 3 and up)Purim Carnival VolunteerPerformer in the Purim ShpielPerformer in the Passover SederTeacher Appreciation Planning

Any other skills or talents you might be willing to share?

Fri, August 7 2020 17 Av 5780