Religious School 2023-2024 Challah Days Registration Form

* Child's First Name:

* Child's Last Name:

Hebrew Name:

* Address:

* City:

* Zip:

* Gender:

* Age:

* Date of Birth:

* Parent's Marital Status:

* Primary email used for communication:

Secondary email (optional):

* Parent/Guardian 1 First Name:

* Parent/Guardian 1 Last Name:

Parent/Guardian 1 Hebrew Name:

Parent/Guardian 1 Home Phone Number:

Parent/Guardian 1 Work Phone Number:

* Parent/Guardian 1 Mobile Phone Number:

Parent/Guardian 2 First Name:

Parent/Guardian 2 Last Name:

Parent/Guardian 2 Hebrew Name:

Parent/Guardian 2 Home Phone Number:

Parent/Guardian 2 Work Phone Number:

Parent/Guardian 2 Mobile Phone Number:

Sibling Name (not yet enrolled in Religious School):

Sibling Birth Date:

Sibling Name (not yet enrolled in Religious School):

Sibling Birth Date:

Are there any custody arrangements that we need to be aware of?

Please list and describe any allergies your child has (food, medications, insect bites, etc.).

Does your child have any of the following (check all that apply):

Hearing ProblemsVision ProblemsAsthmaOther

If yes, or other, please provide additional information.

Does your child take any medications? If yes, please list them here.

Has your child been evaluated and classified as ADD, ADHD, NI or any other special learning situation?

Name two emergency contacts who will assume temporary care of your child in an emergency or lockdown situation, only if you cannot be reached.

* Emergency Contact 1 Name:

Emergency Contact 1 Home Phone Number:

Emergency Contact 1 Mobile Phone Number:

* Emergency Contact 2 Name:

Emergency Contact 2 Home Phone Number:

Emergency Contact 2 Mobile Phone Number:

* Name of Child's Physician:

* Physician's Phone Number:

* Virtual Signature. By writing my name below, I hereby give my consent to the Religious School Director/Administrator, or person designated as such, to make available to my child professional emergency medical care if such care is indicated. It is understood that a conscientious effort will be made to notify my spouse or me before such action is taken. It is further understood that every effort will be made to contact my child's physician prior to any treatment. However, in the event that this is not possible, I give my permission for my child to receive proper medical care by any doctor, nurse, ambulance personnel, paramedic or member of the medical staff of a hospital licensed by the Sate of New Jersey. This is also to certify that my child is in good physical health. He/she has my permission to participate in all activities that are part of the Callah Days Religious School program.

* Please select one:

Please Select OnePBJC Member Payment ($180)Non-Member Payment ($236)2023-2024 Religious School Challah Days Payment

Sat, May 10 2025
12 Iyyar 5785

Today's Sefirah Count Is 27

היום שבעה ועשרים יום שהם שלשה שבועות וששה ימים לעמר

Today's Calendar

Preliminary Prayers

: 9:30am

Shabbat Services

: 9:45am

Friday Night

Candle Lighting

: 7:51pm

Friday Night Shabbat Services

: 8:00pm

Shabbat Day

Bode & Sawyer Ehudin B'nai Mitzvah

Preliminary Prayers

: 9:30am

Shabbat Services

: 9:45am

Upcoming Programs & Events

May

No Religious School
Sunday, May 11

May

Sisterhood Book Club
Monday, May 12 7:30pm

May

Religious School
Tuesday, May 13 4:00pm

May

Kitah Hey (7th) Graduation - Lech Lecha Moviing Up Ceremony
Tuesday, May 13 7:00pm

May

Sisterhood Book Club
Wednesday, May 14 1:00pm

This week's Torah portion is Parshat Achrei Mot-Kedoshim

Shabbat, May 10

Candle Lighting

Shabbat, May 10, 7:45pm

Pesach Sheni

Monday, May 12

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Sat, May 10 2025 12 Iyyar 5785