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Keshet Registration 2024-2025
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Keshet Registration 2024-2025
*
Child's Name
*
Gender
N/A or Unknown
Male
Female
*
Date of Birth
Child’s Hebrew Name [if any]
*
Address
*
City
*
Zip
*
Home phone #
*
Are you a member of any Rochester synagogue?
Please Select One
Please Select
Yes
No
*
Will this be his/her first time in a preschool program?
Yes
No
Which synagogue are you a member of?
Temple Beth El
Temple B'rith Kodesh
Temple Sinai
Temple Beth David
Beth Shalom
Light of Israel
Other
If other, where?
Program Selection
*
Child's age of December 1, 2024
Please Select One
Please Select
18 months - 24 months
2 years
3 years
4 years
Days per week:
2 Days a Week
3 Days a Week
18-24 month old children are eligible for 2 and 3 day weeks.
Days to attend:
Tuesday
Wednesday
Thursday
Days per week:
2 Days a Week
3 Days a Week
5 Days a Week
2-year-old children are eligible for 2, 3, and 5 day weeks.
Days to attend:
Monday
Tuesday
Wednesday
Thursday
Friday
Days per week:
3 Days a Week
5 Days a Week
3-year-old children are eligible for 3 and 5 day weeks.
Days to attend:
Monday
Tuesday
Wednesday
Thursday
Friday
5 Days a Week
5 Days a Week
4-year-old children are eligible for a 5 day week only.
*
Child's age of December 1, 2024
Please Select One
Please Select
18 months - 24 months
2 years
3 years
4 years
Days per week:
2 Days a Week
3 Days a Week
18-24 month old children are eligible for 2 and 3 day weeks.
Days to attend:
Tuesday
Wednesday
Thursday
Days per week:
2 Days a Week
3 Days a Week
5 Days a Week
2-year-old children are eligible for 2, 3, and 5 day weeks.
Days to attend:
Monday
Tuesday
Wednesday
Thursday
Friday
Days per week:
3 Days a Week
5 Days a Week
3-year-old children are eligible for 3 and 5 day weeks.
Days to attend:
Monday
Tuesday
Wednesday
Thursday
Friday
5 Days a Week
5 Days a Week
4-year-old children are eligible for a 5 day week only.
Primary Parent Information
*
Parent/Guardian Name
*
Email Address
*
Cell Phone #
*
Work Phone #
*
Home Phone #
*
Occupation
*
Are you Jewish?
Yes
No
Home Address (if different from child)
Secondary Parent Information
Parent/Guardian Name
Email Address
Cell Phone #
Work Phone #
Home Phone #
Occupation
Are you Jewish?
Yes
No
Home Address (if different from child)
*
Name of Emergency contact:
*
Relationship
*
Phone #
*
Pediatrician Name
*
Phone #
*
Dentist Name
*
Phone #
Permission
My child, named above, has permission to attend all supervised field trips and activities of Keshet Preschool from September 2024 – June 2025. I/We understand that reasonable vigilance in the care and supervision of the children will be exercised. Beyond this I/We will not hold the school or those supervising the trip responsible.
*
Signature of Parent or Guardian
*
Date of Initial
I authorize the use of photographs of my child for Keshet advertising. No names will ever be used without additional parent permission.
Please Select One
YES
NO
*
Signature of Parent or Guardian
*
Date of Initial
I authorize the use of my child's photograph for in-house purposes only, including newsletters and emails.
Please Select One
YES
NO
*
Signature of Parent or Guardian
*
Date of Initial
Transportation
These are the people that you are allowing to pick up your child. Otherwise, we will need
written permission
to dismiss your child to anyone not noted on this list
Name and Phone Number
Name and Phone Number
Alerts
Things Keshet should know about my child
Allergies and treatment:
Medications:
Accidents, illnesses or traumas:
Developmental Information
Please explain any concerns that you might have about your child’s development
:
Social:
Emotional:
Physical:
Techniques for calming your child when upset:
Special interests your child has:
Other information, about your child, that you would like our staff to be sensitive to:
Pandemic Information
Please note that in the event that we need to shut down for any pandemic, you have the right to choose if your child continues with digital learning. If you do choose this option, you will be given materials for two weeks at a time, as well as access to daily virtual lessons on the days your child attends. If you do not choose to have your child continue digitally, you will not receive materials or have access to digital learning. You will receive a credit for the aomunt of time we are closed.
*
This agreement is made between Temple Beth El, on behalf of Keshet Preschool, 139 Winton Road South, Rochester, NY 14610 and the undersigned parent(s) or guardian(s) of:
Parental Agreement
*
We have read and understand this enrollment contract and agree that by signing below it we accept responsibility for all financial obligations contained herein.
Financial Agreement
*
Persons(s) responsible for payments to Temple Beth El (please type names below, this will act as a legal signature).
Payer Agreement
*
I understand that, if paying by charge card, there will be a 3% surcharge applied to offset necessary system fees. If you would like to pay by paper check, please call the office at (585)473-1770 to discuss options.
Credit Card Agreement
Please be sure to alert our staff if any issues or concerns develop throughout the year. Sometimes changes at home will affect a child’s behavior in school. This information will help us to help your child through any difficulties.
We are committed to a close partnership between home and school.
A payment plan must be set up upon confirmation with full payment due by April 30, 2025. If you do not set up a plan, one will be set up for you, recurring on the 1st of every month starting September1, 2024.
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