Registration 2026-27

First child*

Tier 1 $765 per childTier 2 $650 per child (subsidized Rate)
Student Information
Full Name*
First Name Last Name
Hebrew Name*
Gender*

MaleFemale
Birth Date*

Month Day Year
Time of birth
School*
Grade entering*
Previous Jewish Education
Does your child read basic Hebrew?

YesNo
Does your child have learning difficulties with general studies?

YesNo
Explain
Additional notable Information* Please let us know if there are any allergies or other important information we need to be aware of.
Add second child

$650 per child (Sibling Discount)
Second child Student Information
Full Name*
First Name Last Name
Hebrew Name*
Gender*

MaleFemale
Birth Date*

Month Day Year
Time of birth
School*
Grade entering*
Previous Jewish Education
Does your child read basic Hebrew?

YesNo
Does your child have learning difficulties with general studies?

YesNo
Explain
Additional notable Information* Please let us know if there are any allergies or other important information we need to be aware of.
Add third child

$650 per child (Sibling Discount)
Third Child Student Information
Full Name*
First Name Last Name
Hebrew Name*
First Name Last Name
Gender*

MaleFemale
Birth Date*

Month Day Year
Time of birth
School*
Grade entering*
Previous Jewish Education
Does your child read basic Hebrew?

YesNo
Does your child have learning difficulties with general studies?

YesNo
Explain
Additional notable Information* Please let us know if there are any allergies or other important information we need to be aware of.

Home Address*

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

Parents Information
Mother's Name*
First Name Last Name
Mother's Cell*

Area Code Phone Number
Mother's E-mail*
Name & Address of Employment
Mother's Hebrew Name
Father's Name*
First Name Last Name
Father's E-mail*
Father's Cell*

Area Code Phone Number
Name & Address of Employment
Father's Hebrew Name
Is Mother Jewish?*

YesNo
Is Father Jewish?*

YesNo
Was the child's biological maternal grandmother born Jewish?*

YesNoI don't know
Any Adoptions or conversions in the family (including grandparents)*

YesNoNot Sure
If yes, please explain
Best way to send Hebrew School updates:*

Cell PhoneMother's EmailFather's Email
I authorize JSA to take my child on school trips. (you will be notified prior to any trips)
I authorize JSA to take pictures/video of my child and use them for publicity purposes (i.e., Brochures, Webs
*

In the event I cannot be reached, I hereby grant permission to the staff of JSA to treat and/or provide a physician or hospital to give emergency treatment to my child
Parent Initial*
Emergency Information
Full Name*
First Name Last Name
Phone Number*

Area Code Phone Number
Pediatrician*
Phone Number*

Area Code Phone Number
Payment
Please indicate if you'de like to pay all in full or monthly thru December. For scholarships please email [email protected]
Optional Donation to the Aviva Leah Scholarship Fund

$36$50$100
Total

$0.00

I would like to pay today:Full amount20% minimum: $0.00 $
If partial payment is selected, we will charge your card monthly through December, till the full payment is complete.
If you need other payment arrangements, or scholarships, please don't hesitate to call Rabbi Sandhaus at 845-440-7592 or email at [email protected]

Payment

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Updates

2021-2022 Registration
is now open!
Click here to register

Questions?
Call 845-440-7592 or email [email protected]

Upcoming events

Sep. 12, 2026

Second Saturday Shabbat Services and Kiddush

Join on the second Saturday of each month for an energizing and inspiring Shabbat service and Kiddush.
9:30am Kabbalah class
10:30am Services
11:00am Torah reading and ...

Oct. 10, 2026

Second Saturday Shabbat Services and Kiddush

Join on the second Saturday of each month for an energizing and inspiring Shabbat service and Kiddush.
9:30am Kabbalah class
10:30am Services
11:00am Torah reading and ...

Nov. 14, 2026

Second Saturday Shabbat Services and Kiddush

Join on the second Saturday of each month for an energizing and inspiring Shabbat service and Kiddush.
9:30am Kabbalah class
10:30am Services
11:00am Torah reading and ...

No synagogue membership or affiliation required.

Educate Your Child... Educate a Generation

Student Information

Second child Student Information

Third Child Student Information

Parents Information

Emergency Information

Payment