2023-24 Education Center Enrollment - Form - Jewish Community of Greater Stowe

Thank you for your interest in enrolling your child/ren in our education programs. We are delighted to learn and celebrate and grow together!
PLEASE NOTE: our fee structure is "pay what you can, pay what you will": the costs you will see tallied are the actual costs of educating a child in the program chosen; you have not yet been charged.
At completion of the form you'll be asked to enter the total amount for all students you are able to pay. Please consider if you are able to close the gap or exceed our actual costs.
Thank you in advance for being a part of the Olam Chesed Education Center, building a world of loving kindness by bringing your children here to blossom into the mensches we know they are!

* Is your family new to our school?

Please Select OneNoYes

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 OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf 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 Name

* Emergency Contact Phone

* Emergency Contact Relationship

Section B: Student Enrollment Information

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

* Grade in school

* Student 1 Hebrew Name

Student 1 Nickname (if applicable)

Student 1 Enrollment

* 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 OneNoYes (IEP or 504)Please email any 504 or IEP to the education director, beth.liberman@jcogs.org

Student 1 learning needs

* Student 1 Allergies or Medications

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

Student 1 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

* Student 1 Dietary Needs

Please Select OneNoYesDoes your child have dietary needs we should follow?

Student 1 Dietary Details

Please describe any special dietary needs for student 1.

Student 2 Information

* Student 2 First Name

* Student 2 Last Name

* Student 2 Birthdate

* Grade in school

* Student 2 Hebrew Name

Student 2 Nickname (if applicable)

Student 2 Enrollment

* 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 OneNoYes (IEP or 504)Please email any 504 or IEP to the education director, beth.liberman@jcogs.org

Student 2 learning needs

* Student 2 Allergies or Medications

Please Select OneNoYesDoes 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.

* Student 2 Dietary Needs

Please Select OneNoYesDoes your child have dietary needs we should follow?

Student 2 Dietary Details

Please describe the dietary needs.

Student 3 Information

* Student 3 First Name

* Student 3 Last Name

* Student 3 Birthdate

* Grade in school

* Student 3 Hebrew Name

Student 3 Nickname (if applicable)

Student 3 Enrollment

* 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 OneNoYes (IEP or 504)Please email any 504 or IEP to the education director, beth.liberman@jcogs.org

Student 3 learning needs

* Student 3 Allergies or Medications

Please Select OneNoYesDoes 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.

* Student 3 Dietary Needs

Please Select OneNoYesDoes your child have dietary needs we should follow?

Student 3 Dietary Details

Please describe the dietary needs.

Student 4 Information

* Student 4 First Name

* Student 4 Last Name

* Student 4 Birthdate

* Grade in school

* Student 4 Hebrew Name

Student 4 Nickname (if applicable)

* Student 4 Enrollment

* 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 OneNoYes (IEP or 504)Please email any 504 or IEP to the education director, beth.liberman@jcogs.org

Student 4 learning needs

* Student 4 Allergies or Medications

Please Select OneNoYesDoes 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.

* Student 4 Dietary Needs

Please Select OneNoYesDoes your child have any dietary needs?

Student 4 Dietary Details

Please describe any special dietary needs.

Section C: Release Forms

By signing my name below, my child(ren) have permission to participate in the Religious School at The Jewish Community of Greater Stowe (JCOGS). In consideration of my child(ren)'s acceptance as a religious school student, I hereby waive any and all claims against JCOGS, its agents and its employees that may arise out of any injury, loss or damage suffered by my child(ren) during any religious school activity. I hereby authorize the Education Director, or person designated by the Education Director, to obtain emergency medical care for my child(ren) in the event such care is indicated. I give my permission for my child(ren) to receive emergency medical care by any nurse, doctor, paramedic or member of a medical staff of a hospital licensed by the State of Vermont. I understand that every effort will be made to notify a parent/guardian prior to treatment.

I certify that my child(ren) is(are) in good physical health. They have my permission to participate in all activities that are part of the regular religious school program.

* Medical Release: Enter your name below

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

Insurance Cards

Upload a photo of insurance cards for each student.

Media Release

From time to time your child’s photo may be taken in our classrooms or special events. We use these photos in the synagogue newsletters, on our synagogue website as well as our Facebook groups and other publicity materials.

* Media Release

Please Select OneI grant permission for my child's image to be usedI do not grant permission for my child’s image to be used

Section D: Proof of Covid Vaccination\

The Jewish Community of Greater Stowe requires that anyone who enters our building to have their COVID vaccination or they must wear a mask. Please upload an image of your child(ren)'s vaccination cards.

* My Child/Children are vaccinated according to the Vermont state requirements.

My Child/Children are vaccinated according to the Vermont state requirements.

Proof of Covid Vaccination

Please upload your child(ren)'s Covid vaccination cards here.

Total cost to educate your children.

* Enter in the total amount for all students you are able to pay

The cost to run our children's programs is $2500 for Olam Chesed | $1800 for Kinderlach & Gesher | $4900 for Mitzvah per child* | $1800 for Ateed per child.
*Mitzvah requires a minimum payment of $2400 to cover tutoring and other costs specific to the program.

Additional donation to support the children's programs