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TGS 2020 Bar & Bat Mitzvah Program Enrolment
Dear parents,
Use this form to enroll your child in The Great Synagogue's Bar & Bat Mitzvah Program for 2020. Classes will be held one Sunday a month from February to December, for a total of 11 classes throughout the year. Our immersive and engaging program will cover a wide variety of Jewish concepts, philosophies and practices to enrich your child's Jewish learning as they prepare for their Bar or Bat Mitzvah.
The cost for the entire program for the year is $300.
Details of Student
*
Student's Surname
*
Student's First & Middle Name(s)
*
Gender
Please Select One
Male
Female
*
Date of Birth
Born:
Before Sunset
After Sunset
This is used to calculate the student's Hebrew birthday.
*
Year in School in 2020
*
School Student Attends
Student Medical Details
Does the student have:
Asthma
ADHD
Allergies
None
If allergies, please specify:
*
Does the student take/need medication?
Please Select One
No
Yes
Please specify:
Any other issues that we should be aware of:
Details of Parent or Guardian 1
*
Title
Please Select One
Mr
Mrs
Ms
Dr
Prof
*
Parent's First Name
*
Parent's Surname
*
Relationship to Student
Please Select One
Mother
Father
Other
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
Mr
Mrs
Ms
Dr
Prof
Parent's First Name
Parent's Surname
Relationship to Student
Please Select One
Mother
Father
Other
Please specify:
Mobile Phone
Work Phone
Email
Residential Address
Please Select One
Same as Parent/Guardian 1
Different 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
*
Full Course - $300
Full Course - $300
Please 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.
Total
Sat, 16 January 2021 3 Shevat 5781