Religious School Registration for 2025-2026

2025-2026 Religious School Registration

Welcome to the Temple Kol Ami Religious School
Jewish education instills knowledge and a love of Judaism that will last a lifetime. The Temple Kol Ami Religious School facilitates students to build a strong sense of Jewish identity. Our Judaic and Hebrew curriculum, family programs, and holiday celebrations nurture and support students and their families along their Jewish journeys.

There is no tuition increase for 2025-2026. Your cost may change depending on the grade of your student(s). We are committed to supporting all families that wish to participate in religious school, regardless of finances. If you need tuition assistance, please contact Clara Silver, Temple Kol Ami's executive director at (248) 661-0040 or clara@tkolami.org. Religious school students must be members of Temple Kol Ami. Please contact the Temple office if you require membership information.

Referral Tuition Credit for Returning Families
Returning families are encouraged to share this experience with other families. A currently enrolled family will receive a $500 credit toward their total annual tuition once their referral family, new to TKA, joins and enrolls their child(ren) in religious school.

Please reach out to me with any questions.

Margery Jablin,
Religious School Administrator
school@tkolami.org

Religious School Opening Dates:
Sunday, September 7, 2025 and Wednesday, September 10, 2025

2025-2026 Tuition
Grades PreK: $0
Grades K-4: $800
Grades 5-7: $1200

Sibling discount:
The first enrolled child will be charged full tuition. Each additional sibling's tuition will be discounted $150.

Religious School Hours
Sundays: 9:30am - 12:00pm
Grades Pre-K through 7 and Madrichim

Wednesdays: 5:15pm - 6:45pm
Grades 5-7

Please select how you prefer to pay:

Pay in full (due September 7, 2025)Pay in two installments (due September 2025 and January 2026)Pay monthly (must set up 8 automatic payments, Sept-Apr)Based on the information you provide on this form, the total tuition amount will be added to your account in August 2025, and billed based on the preference you selected. For questions about billing and payment, please contact Julie in the TKA Office at (248)661-0040 Ext. 228.

PARENT(S)/GUARDIAN(S) INFORMATION

Primary Parent/Guardian First Name:

Primary Parent/Guardian Last Name:

Primary Parent/Guardian Email:

Primary Parent/Guardian Phone Number:

Primary Address Number and Street:

Primary Address City:

Primary Address State:

Primary Address ZIP:

Secondary Parent/Guardian First Name:

Secondary Parent/Guardian Last Name:

Secondary Parent/Guardian Email:

Secondary Parent/Guardian Phone Number:

Is the Secondary Parent/Guardian's Address the same as the the Primary?

Secondary Parent/Guardian Address Number and Street:

Secondary Parent/Guardian Address City:

Secondary Parent/Guardian Address State:

Secondary Parent/Guardian Address ZIP:

EMERGENCY CONTACTS

In the event of an emergency, every effort will be made to contact the parent(s)/guardian(s). Please provide additional an emergency contact if parent(s)/guardian(s) are unreachable:

Emergency Contact Name:

Emergency Contact Number:

Emergency Contact Relationship to Student:

How many children are you registering for Religious School?
Please select the number of children you'd like to register.

CHILD 1 INFORMATION

First Name:

Middle Name:

Last Name:

Hebrew Name:

Age:

Birthdate:

Gender:

Child's Primary Address:

Religious School Grade:

Secular School Grade:

CHILD 1 MEDICAL INFORMATION

Allergies (medications, foods, environment, etc)

Reactions, Seriousness, and Actions Necessary

Other Medical Conditions

Medications taken on a regular basis?

Dietary Restrictions:

Is your child in any special education program in public school or does your child have any special learning needs? If applicable please tell us the current 504 plan or IEP:

Knowing your child better than anyone, what else should we know about your child to create the best learning situation?

Are there any family situations (e.g. divorce, illness) of which we should be aware?

CHILD 2 INFORMATION

First Name:

Middle Name:

Last Name:

Hebrew Name:

Age:

Birthdate:

Gender:

Child's Primary Address:

Religious School Grade:

Secular School Grade:

CHILD 2 MEDICAL INFORMATION

Allergies (medications, foods, environment, etc)

Reactions, Seriousness, and Actions Necessary

Other Medical Conditions

Medications taken on a regular basis?

Dietary Restrictions:

Is your child in any special education program in public school or does your child have any special learning needs? If applicable please tell us the current 504 plan or IEP:

Knowing your child better than anyone, what else should we know about your child to create the best learning situation?

Are there any family situations (e.g. divorce, illness) of which we should be aware?

CHILD 3 INFORMATION

First Name:

Middle Name:

Last Name:

Hebrew Name:

Age:

Birthdate:

Gender:

Child's Primary Address:

Religious School Grade:

Secular School Grade:

CHILD 3 MEDICAL INFORMATION

Allergies (medications, foods, environment, etc)

Reactions, Seriousness, and Actions Necessary

Other Medical Conditions

Medications taken on a regular basis?

Dietary Restrictions:

Is your child in any special education program in public school or does your child have any special learning needs? If aplicable please tell us the current 504 plan or IEP:

Knowing your child better than anyone, what else should we know about your child to create the best learning situation?

Are there any family situations (e.g. divorce, illness) of which we should be aware?

CHILD 4 INFORMATION

First Name:

Middle Name:

Last Name:

Hebrew Name:

Age:

Birthdate:

Gender:

Child's Primary Address:

Religious School Grade:

Secular School Grade:

CHILD 4 MEDICAL INFORMATION

Allergies (medications, foods, environment, etc)

Reactions, Seriousness, and Actions Necessary

Other Medical Conditions

Medications taken on a regular basis?

Dietary Restrictions:

Is your child in any special education program in public school or does your child have any special learning needs? If applicable please tell us the current 504 plan or IEP:

Knowing your child better than anyone, what else should we know about your child to create the best learning situation?

Are there any family situations (e.g. divorce, illness) of which we should be aware?

MEDICAL SAFETY INFORMATION
Students will NOT be allowed to attend religious school without up-to-date medical and health insurance information.

Students will NOT be allowed to administer any medication, prescription or non-prescription, without written permission from the parent(s)/guardian(s). Prescription medication(s) must be in original packaging with original pharmacy label(s) and accompanied by written instructions for proper administration, preferably by the prescribing medical professional.

Please contact the Religious School Administrator, Margery Jablin, with any questions or concerns regarding medical information.

MEDICAL AND HEALTH INSURANCE INFORMATION

Physician's Name:

Physician's Phone Number:

Health Insurance Company:

Heath Insurance Company Phone Number:

Name of Policy Holder:

Policy Number:

Insurance Group Number:

Insurance Company Address:

SECONDARY MEDICAL AND HEALTH INSURANCE INFORMATION (if applicable)

Physician's Name:

Physician's Phone Number:

Secondary Health Insurance Company:

Secondary Health Insurance Company Phone Number:

Name of Policy Holder:

Secondary Policy Number:

Secondary Group Number:

Secondary Insurance Company Address:

EMERGENCY CARE AUTHORIZATION

In the event that my/our enrolled child has an urgent medical incident while participating in Temple Kol Ami Religious School during official religious school hours, and no parent(s)/guardian(s) can be reached and/or the situation appears to require immediate intervention, I/we grant Temple Kol Ami Religious School staff permission to take the action(s) they deem appropriate, including but not limited to: administering rescue medications as listed on this form and appropriately provided for by me/us, contacting emergency medical services (EMS), transporting my child by private vehicle or ambulance to an appropriate medical facility, authorizing qualified medical authorities to treat my child as they deem necessary. Typing my name below verifies that I have read, understood, and approve this authorization.

Primary Parent/Guardian Name:

Primary Parent/Guardian Signature:
By typing my name in the signature field, I understand that I am electronically signing this form.

Today's Date:

Additional Information/Notes:

Media/Marketing/Website Release
I understand that my child's video or static image may be used by Temple Kol Ami for marketing purposes through a variety of print and/or electronic platforms. If I do not want my child's image used, I must check the box below.

I/we do not want my/our child(ren)'s image used by Temple Kol Ami.
I/we do not want my/our child(ren)'s image used by Temple Kol Ami.

Thu, June 26 2025 30 Sivan 5785