Building Blocks Religious School 2023-2024

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Sunday, August 20, 2023 • 3 Elul 5783

10:00 AM - 12:00 PMCongregation Or VeShalom

Building Blocks, Come Grow with Us, is the Religious School program at Congregation Or VeShalom for children ages 3 - 9. Classes will be held on the first and third Sundays of each month.

Register

Sessions will be held from 10:00 am - Noon on the following dates:

Religious School Sundays
August 20, 2023
September 10, 2023
September 17, 2023 (Rosh Hashana Day 2)
October 1, 2023 (Sukkot Day 2)
October 15, 2023
November 5, 2023
NO CLASS on November 19 – Join us at the Sisterhood Hanukkah Bazaar & Food Festival
December 3, 2023
December 17, 2023
January 7, 2024
January 21, 2024
February 4, 2024
February 18, 2024
March 3, 2024
March 17, 2024
April 7, 2024
April 21, 2024
May 5, 2024
May 19 2024

FAMILY INFORMATION

* Parent/Guardian (1) Name

Parent/Guardian (2) Name

* Parent/Guardian (1) Best Phone Number

Parent/Guardian (2) Best Phone Number

* Parent/Guardian (1) Email

Parent/Guardian (2) Email

Parent/Guardian (1) Street

Parent/Guardian (2) Street (If Different)

Parent/Guardian (1) City

Parent/Guardian (2) City (If Different)

Parent/Guardian (1) State

Parent/Guardian (2) State (If Different)

Parent/Guardian (1) Zip

Parent/Guardian (2) Zip (If Different)

Emergency Contact Name

Emergency Contact Cell Phone

STUDENT INFORMATION

Student (1) First Name

Student (2) First Name

Student (3) First Name

Student (1) Last Name

Student (2) Last Name

Student (3) Last Name

Student (1) Hebrew Name

Student (2) Hebrew Name

Student (3) Hebrew Name

Student (1) Birthday

Student (2) Birthday

Student (3) Birthday

School Grade (as of 9/1/23) - Student (1)

School Grade (as of 9/1/23) - Student (2)

School Grade (as of 9/1/23) - Student (3)

Is there anything you'd like to share about student (1)?

Is there anything you'd like to share about student (2)?

Is there anything you'd like to share about student (3)?

ALLERGY INFORMATION

Does Student (1) have any allergies?

Yes. My child has allergies.No. My child has no allergies.

Does Student (2) have any allergies?

Yes. My child has allergies.No. My child has no allergies.

Does Student (3) have any allergies?

Yes. My child has allergies.No. My child has no allergies.

List all allergies student (1):

List all allergies student (2):

List all allergies student (3):

FAMILY MEDICAL INFORMATION

* Electronic Signature for Medical Release. Please enter your full name in the box below.

Doctor's Name:

Doctor's Phone Number:

Health Insurance Company

Policy ID Number

Group Number

Medical Release

I hereby authorize the Rabbi or Executive Director, or person designated by the Rabbi or 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 licensed by the State of Georgia. 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.

PUBLICITY RELEASE

From time to time your child(ren)’s photo may be taken in our classrooms or special events. We use these photos in synagogue eblasts, on printed materials or in other advertisements for OVS.

Yes, I give my permission for my child(ren)'s photo to be used.No, I do not give permission for my child(ren)'s photo to be used.

By clicking yes, you are agreeing that you child(ren)'s photograph may be used in synagogue eblasts, on printed materials or in other advertising for OVS or Building Blocks.

Number of Children - OVS Member

Cost of Building Blocks is $200 per child for OVS members.

Number of Children - Non OVS Member

Cost of Building Blocks is $300 per child for non OVS members.

Total Due

Please click submit to advance to the payment page.

If you require financial assistance, please contact Adam Kofinas, Executive Director, at 404-633-1737.

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MayMay 5 , 2024

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