CKids Returning Families - Application

We are currently accepting applications for the 2021-22 school year. Please fill out ALL required fields of this form. If you have any questions or concerns you'd like to discuss with us, please call 704 366 3984 or email [email protected]

Please Note: Ohr HaTorah membership is recommended for families participating in the CKids program. For more info about membership call Brenda at 704 366 3984.

We look forward to a wonderful year of learning and growth!

Please submit your CKids payment , then return to this form to complete your registration

Full Name*

First NameLast Name

Grade*

Which CKids will you be joining?

CKids in PersonCKids Virtual

Full Name

First NameLast Name

Grade

Which CKids will you be joining?

CKids in PersonCKids Virtual

Full Name

First NameLast Name

Grade

Which CKids will you be joining?

CKids in PersonCKids Virtual

Full Name

First NameLast Name

Hebrew Name

Birth Date

MonthDayYear

School

Grade

Phone Number

Area CodePhone Number

E-mail

Phone Number

Area CodePhone Number

E-mail

Change of Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Change of Parents marital status

MarriedDivorcedSeparated

If separated or divorced, please respond to the following questions: With whom does the child(ren) reside? To whom shall school correspondence be sent?

Emergency Contact #1*

First NameLast Name

Phone Contact #1*

Area CodePhone Number

Emergency Contact #2*

First NameLast Name

Phone Contact #2*

Area CodePhone Number

1. Is your child/children allergic to any foods? If yes, please explain in detail

2. Is there any special medical or any other information regarding your child/children that our school should be aware of?

As the parent(s) or legal guardian(s) of child/ren noted above, I/we authorize any adult acting on behalf of CKids to hospitalize or secure treatment for my child. I further agree to pay for all charges for that care and/or treatment. It is understood that, if time and circumstances reasonably permit, the staff will try to communicate with me prior to such treatment.

I/we hereby give permission for my child/ren to attend all field trips and outings organized by CKids. I/we hereby give permission for my child/ren to be transported by CKids on field trips.

I/we allow my child/ren to be photographed while participating during school activities. I/we understand that these photographs may be used for publicity purposes.

I accept the terms above*

Accept

Guardian Digital Signature*

First NameLast Name

CKids Returning Families - Application

Returning Students

Student 1

Student 2

Student 3

New Student

Update Family & Contact Information

Mother

Father

Household

Emergency Medical Information (required)

Terms

Kids

Teens

Adults

Women & Girls

The Synagogue

Visitors