Nehar Shalom FAMILY LEARNING CIRCLE Registration Form 2024

Thank you for participating in Nehar Shalom’s family education programs for the 2024!

We are so excited to play and learn with you and your family this year. Please take a few minutes to fill out this form so we can get to know your family before our programs begin.

Membership at Nehar Shalom is expected for Mishpacha families and encouraged for Family Learning Circle participants.

Please complete this form for your child. For more than one child, continue to scroll down and complete the additional information accordingly.

Adult(s) information

This address will receive a confirmation email

First and Last Name of the parent/guardian (Adult 1) completing this form:

Adult 1's pronouns:

Adult 1 cell phone number:

Adult 1 mailing address:

If your family has a second adult, please list their first and last name, as well as their preferred pronouns, here. (If none, please write "N/A." If there are additional adults in your family, please put their names and pronouns here as well.):

Email addresses for other adults in your household:

Mobile phone number(s) for other adults in your household:

Mailing address for other adult(s) in your household (if different than adult 1's.):

In case of emergency, if we cannot reach the people previously listed, please provide the name, relationship and cell phone number of one or two trusted people to call:

Nehar Shalom may use photos taken of my children during family education programs for the website or other promotional materials:

Yes No

Student information

How many children are you enrolling in our programs?

1 2 3 4

Child 1 name:

Child 1 birthday (month/day/year)

Grade during 2023-2024 School Year (if student is younger than kindergarten age, please share what if any kind of daycare/preschool they attend.)

Child 1 pronouns:

Please share a bit about Child 1, their relationship to Jewish life and learning, and anything else it may be helpful for us to know:

Child 2 name:

Child 2 birthday (month, day, year):

Grade during 2023-2024 School Year (if student is younger than kindergarten age, please share what if any kind of daycare/preschool they attend.)

Child 2 pronouns:

Please share a bit about Child 2, their relationship to Jewish life and learning, and anything else it may be helpful for us to know:

Child 3 name:

Child 3 birthday (month, day, year):

Grade during 2023-2024 School Year (if student is younger than kindergarten age, please share what if any kind of daycare/preschool they attend.)

Child 3 pronouns:

Please share a bit about Child 3, their relationship to Jewish life and learning, and anything else it may be helpful for us to know:

Do any of your children have an individualized education plan at school? If so, please take a few minutes to describe their learning needs and strategies for supporting them. (We will follow up individually to learn more about how to work best with your family.)

What are you most looking forward to or hoping to accomplish by enrolling your child(ren) in Family Learning Circle?

Do you have concerns that the teachers should have in mind as we prepare our programs this year, or questions that you would like answered?

Please share medical concerns, allergies or food sensitivities about which we should be aware while your child participates in Nehar Shalom programming.

Please share other ideas, suggestions or information that we can use to develop our relationship with your child(ren) we would be most appreciative.

Membership Information

Family Learning Circle:

As a resource for Jews in Jamaica Plain, our Family Learning Circle Program is open to any families who are interested in participating. Any family may participate, though membership at the Nehar Shalom Community Synagogue is encouraged. We are in the process of developing this program and your input is most welcome.

FLC schedule:
Sundays from 3:30-4:30 on
Feb 5th
Mar 5th
Apr 2nd
May 7th
Jun 4th

Payment Information

Nehar Shalom is committed to making our Jewish learning opportunities available for all who seek them in the community. The tuition numbers listed below reflect the cost of the program in recent years.

If the cost listed is prohibitive, please be in touch with Sherry Grossman, Chair of the Education Committee, at sherrygcoach@gmail.com, to confirm a tuition amount and payment plan that is reasonable for your circumstances.

Those who are able are warmly encouraged to consider making an additional donation to help ensure these programs continue to be available.

Family Learning Circle (FLC). Our community values making this program accessible for all and decided to make it free of charge. The activities run entirely based on the contributions of our members and participants. Please consider making a donation as you are able. Thank you for being a member of our community! We look forward to celebrating the holidays and learning together!

Suggested donations:

$160 for one child
$270 for two children

$320 for three or more children

If you are going to pay, would you like to pay by: Credit Card/ACH - please click on the link that will appear on the confirmation page after you hit Submit Form Bank Check Personal Check

If paying by Credit Card/ACH check please click on the link that will appear on the confirmation page after you hit Submit Form or use the link below.

If paying by check please send to:

Nehar Shalom Community Synagogue
PO Box 301787
Jamaica Plain, MA 02130

Thank you for your support.

Suggested Donation

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Nehar Shalom Family Education Program
FAMILY LEARNING CIRCLE Registration Form 2024

Nehar Shalom FAMILY LEARNING CIRCLE Registration Form 2024

Description

Please Fix the Following