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Kol Nidre Campaign 2023 / 5784
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Etz Chaim Website
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Preschool Registration 2024-25
Please verify reCaptcha before submitting the form.
*
Current Synagogue Affiliation
Please Select One
Current Etz Chaim Member
Not a Member of Etz Chaim
If not currently a member, would you like to receive information about upcoming Etz Chaim activities?
Yes
No
Family Information
*
Parent Names
*
Home Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
*
Cell Phone Number
*
Additional Phone Number
*
Primary Email Address
Number and Status of Preschool Children being Enrolled
Select One
Member - 1 child
Member - 2 children
Member - 3 children
NON-Member - 1 children
NON-Member - 2 children
NON-Member - 3 children
If you are not currently a member of Congregation Etz Chaim, please choose the Non-member status.
Etz Chaim member - $100.00 per child registration fee
Non-member - $125.00 per child registration fee
Student Information and Program Selection
Enter the Number of Preschool Children being Registered (same number as above)
0
1
2
3
*
Child's First Name
*
Child's Last Name
Nickname
*
Birthday
*
Gender
Please Select One
Female
Male
T-Shirt Size (For the 2025-2026 school year)
2T
4T
XS
S
*
Age Group
Select One
14 mos - 23 mos (child must be walking in order to attend)
2 yr
3 yr
PreK
Daily Schedule, 9:30 am - 1:30 pm (everyone)
- check any additional times that apply.
Morning Care
7:00 am - 9:30 am
7:00 am - 9:30 am
8:00 am - 9:30 am
8:00 am - 9:30 am
After Care
1:30 pm - 5:00 pm
1:30 pm - 5:00 pm
1:30 pm - 6:00 pm
1:30 pm - 6:00 pm
*
Weekly Schedule
Please Select One
5 Day Option
4 Day Option - not available for Pre-K
3 Day Option - not available for Pre-K
2 Day Option - not available for 3yr & Pre-K
Final availability of days will be determined by enrollment
Day Preferences
- check all that apply
Monday
Monday
Tuesday
Tuesday
Wednesday
Wednesday
Thursday
Thursday
Friday
Friday
TOTAL REGISTRATION FEE DUE
Fri, January 17 2025 17 Tevet 5785
