Religious School Registration 2024-2025 - Form - Congregation Beth Shalom Napa Valley

Please fill this form out for each child.

(CBS members, please login first)

Religious School Fee Schedule 5785 / 2024-2025

Sundays from 9:30am to 12pm:

Kindergarten - 5th Grade CBS Member: $600 per child Non-member: $950 per child
6th - 7th Grade * CBS Member: $800 per child Non-member: $1,600 per child

* It is our expectation that students in Grades 6-7 will attend Religious School on Sundays as well as B'Nei Mitzvah sessions during the week. This is a required component of the B'nei Mitzvah program. Once you have submitted your child's enrollment form for religious school, we will send you the link to request a timeslot for the B'Nei Mitzvah program.

Optional Donation: Youth Scholarship Fund to help fund a child's Jewish education

Financial Aid: No CBS member family is denied a religious education for their children for reasons of financial hardship. If Religious School tuition will place an undue financial burden on your family, please contact Synagogue President Eve Kahn at: president@cbsnapa.org to make special payment arrangements BEFORE REGISTERING.

Student Information

* Last Name:

* First Name:

Hebrew Name:

* Please indicate which gender best describes your child.

* Birthday:

Select your child's grade from the dropdown below (CBS Members must be logged in).

The Total Amount Due and Payment options will appear at the end of this form.

* Current Members in good standing at CBS for 2024-25 | 5785:

Please Select OneYesNo

* CBS MEMBER - Grade in Fall of 2024

* NON-MEMBER - Grade in Fall of 2024

* Day/Secular School:

Student's Email Address:

If applicable. Parents will be copied on any emails sent directly to students.

Student's Cell Number:

If applicable.

* Allergies:

Please list any allergies your child has. If none, list "N/A"

* Medications:

Please list any medications your child is taking and the frequency. If none, list "N/A"

Medical Release Form:

I/We, the undersigned, parent(s) or guardian(s) of:

Student name:

is a minor, and do hereby authorize the staff of Congregation Beth Shalom of Napa Valley, or their authorized representatives, as agents for the undersigned, to consent to medical treatment by a state licensed physician, or staff of a licensed hospital to be administered to my child in the event of accident, injury, sickness, etc., until such time as I may be contacted. I also assume the responsibility for the payment of any such treatment. This release shall remain in effect at all times during the 2024-2025 school year.

First Name of Parent/Guardian:

Last Name of Parent/Guardian:

Date (MM/DD/YYYY):

Photos for Social Media and Promotional Purposes
We often take photos of the children during activities and events. Do you give permission for photos of your child to be featured on Congregation Beth Shalom's social media or used for promotional purposes?

Please Select OneYes, I give permission.No, I do not give permission.

Emergency Contact/Pick Up Information

Persons other than parents/guardians who should be called upon in the event of an emergency and in the event that neither parent can be reached. Please list each person's name and primary phone number:

In the space provided, please also indicate any person(s) who MAY NOT pick your child up from Religious School. Unless told otherwise, we will release your child(ren) to the person who arrives to get them at the end of the school day.

* Contact #1 Name

* Contact #1 Phone Number

* Contact #2 Name

* Contact #2 Phone Number

* The following people MAY NOT pick my child up from Religious School

Please list the names of any person(s) who do NOT have permission to pick your child(ren) up from Religious School.

* Does your child receive any special services in secular/day school? Does your child have an IEP or 504 plan?

Please explain any accommodations your child receives. If none, list "N/A"

* Have there been any recent changes in home or school life that might affect your child's learning and engagement in Religious School?

Please explain. If none, list "N/A"

Is there anything else you would like us to know about your child?

Parent Information

Please Select OneBoth ParentsParent #1Parent #2

Parent #1

* Last Name:

* First Name:

* Street Address:

* City:

State:

* Zip Code:

* Cell Phone:

Home Phone:

Work Phone:

* Email Address:

Registration confirmation will be sent to this email.

* Religious Affiliation:

Parent #2

Last Name:

First Name:

Street Address:

City:

Zip Code:

Cell Phone:

Home Phone:

Email Address:

Registration confirmation will be sent to this email.

Work Phone:

Religious Affiliation:

Mandatory Volunteer Opportunities

The Religious School at CBS needs your help! Jewish holiday celebrations are an important part of your child’s learning experience. During class, the students learn the rituals, prayers, and meaning of the holidays. It’s after class that we come together as a community to celebrate with our children. These special events are organized and facilitated by the parents of the Religious School students.

Please pick one event from the list below to help plan and two other events to assist with on the day of the event. Parents new to our school, don’t worry, you will have the support and guidance of the parents of the older students. Veteran parents, we rely on your wisdom and expertise. We couldn’t do it without you!

Please Select OneI am looking forward to helping as much as I can with the CBS RS programs!

Do you have a special talent you'd like to share with our kids, such as cooking or arts and crafts?

Total Amount Due:

Methods of Payment:

1. Bill to your CBS Member Account and pay with Check or Credit card.

2. Set up automatic payment/s using your credit card/e-check on the payment page.

3. Special Payment Arrangement - enter code provided to you from the CBS office in Promo Code via the payment page **

* There is a convenience fee for all Credit Card of 2.5% per transaction.

** Must have previously discussed arrangement with Synagogue President to have received code.

Please Sign and click the Submit button below to proceed to the payment page. You will then select either your preferred payment method and plan before clicking "Confirm & Continue."

Signature (please type full name)