The Hochberg Academy at Temple Beth Shalom (Grades 8-12)
Registration 2021-2022 / 5782
PLEASE PRINT or TYPE ALL INFORMATION CLEARLY
Parent #1
Parent #2
Siblings:
Emergency Contacts:
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If I cannot be reached in an emergency, I authorize TBS to seek medical attention for my child.
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My child has permission to participate in all class field trips. I will be notified in advance of all trips.
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TBS has my permission to publish photographs taken of my child for use in publications or on website. My child will not be identified by name. I understand we will not receive financial compensation for such publicity.
Fees include: Religious School tuition, Youth Group dues (grades 8-12), light dinner. Fees do NOT include Youth Group trips.
Grades 8-12
Wednesdays 6:00-7:30
$ 200
$ 200
Amount enclosed:
BALANCE:
METHOD OF PAYMENT:
NOTE: The Hochberg Academy refunds fees only in cases of serious illness or family move.