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OJC SCHOOL REGISTRATION FORM 2018-2019



Emergency Contacts:


Pick-up Information: (The following listed names have permission to pick-up this student.)


Consents: (Please check all consents you approve.)
If you wish to rescind this agreement, you may do so at any time in writing to the Educational Director and rescission will take effect upon receipt by the school.

I GRANT permission for a photo/image of this student to be published in the newspaper and on the school or synagogue web site

This may include personally identifiable information such as student name.

I GRANT permission for my child to participate in OJC Religious School trips during this school year.  I, the undersigned, on behalf of myself and my child, hereby expressly release and discharge teachers, employees and members of the Orangetown Jewish Center from any and all causes of actions, claims, damages and other liabilities.

I GRANT permission for my name, address, phone number and email to be printed in the school directory/class list.

 


Medical Information:
In case of accident or serious illness, if the school is unable to reach a parent or emergency contact, I authorize the school to call the physician indicated below and to follow his/her instructions. If the school is unable to reach this physician, the Orangetown Jewish Center has the authority to perform and seek emergency medical treatment.




Registration for the 2018-2019 school year will be only be accepted if you have been issued your certificate of good standing. If you have not received the certificate, please contact Matt Schiering, the OJC financial secretary.

Please note: paying by credit card will incur an additional 3% processing fee.

 

Mon, May 21 2018 7 Sivan 5778