TGS Jewish Enrichment Program Enrolment - Form

Dear parents,

Use this form to enroll your child in The Great Synagogue's Jewish Enrichment Program at Reddam House for the remainder of the 2019 School Year. Classes are held every Wednesday when school is on, besides for Jewish Festivals, from 4:30-5:30pm in the Downstairs Hebrew Room at Reddam.

The cost for the Jewish Enrichment Program at Reddam is based upon the number of classes in each term. Terms 3 & 4 will be $180.

We run a number of exciting excursions and Shabbatons at The Great Synagogue throughout the year. Stay tuned for the full calendar, coming soon!

*If you would like to enroll your child in the Jewish Enrichment Program at Rose Bay or Bellevue Hill Public Schools instead, please click here.

Details of Student

* Student's Surname

* Student's First Name(s)

* Gender

* Date of Birth

Born:

Before SunsetAfter SunsetThis is used to calculate the student's Hebrew birthday.

* Year in School

* School Student Attends

Please Select OneReddam HouseOther

Other School

Student Medical Details

Does the student have:

AsthmaADHDAllergiesNone

If allergies, please specify:

* Does the student take/need medication?

Please Select OneNoYes

Please specify:

Any other issues that we should be aware of:

Details of Parent or Guardian 1

* Title

* Parent's First Name

* Parent's Surname

* Relationship to Student

Please Select OneMotherFatherOther

Please specify:

* Mobile Phone

Work Phone

* Email

*Confirmation email will go to this address*

* Unit/Street no.:

* Street name:

* Suburb/Town:

* Postcode

Details of Parent or Guardian 2

Title

Parent's First Name

Parent's Surname

Relationship to Student

Please Select OneMotherFatherOther

Please specify:

Mobile Phone

Work Phone

Residential Address

Please Select OneSame as Parent/Guardian 1Different Address

Unit/Street no.:

Street name:

Suburb/Town:

Postcode

Media Consent

I/We, the person(s) whose signature appears below, hereby give my/our consent for submitted photos or videos of my child/ren and/or myself to be used by The Great Synagogue and/or any of its officers, employees, contractors or agents (collectively TGS) in the course of or in connection with the operations and activities of TGS.

I/We confirm that I am/ we are authorised to give this permission. I/we give my/our consent for the submitted photograph(s) or video footage to be displayed in newspapers and magazines (whether print or digital), on any TGS website, on any social media platform and in any promotional material or brochures that TGS may use or develop. I/we also release and hold harmless TGS, its contractors, employees and any third party involved in the creation or publication of such material from liability for any claims by me/us or any third party in connection with the use of this/these photograph(s) or video(s).

I/we understand that:
· All material gathered is subject to the editorial discretion of TGS; and
· TGS may at its sole discretion and without being required to consult with me /us, elect to use or not use, all or any of the material gathered.

Type Name to Confirm Media Consent

Date

Re-Type Name to Confirm Media Consent

The Great Synagogue reserves the right to request your written signature at a later date.

Payment

* Terms 3 & 4 - $180

Full 2019 Year - $360Terms 2-4 - $270Terms 3 & 4 - $180Please tick the box to accept the charge.

If you are unable to make full payment at this time, please contact The Great Synagogue office on admin@greatsynagogue.org.au or 9267 2477 to discuss other payment options.

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