New Student Enrollment

We are pleased to open a new and improved JKC program to suit the needs of public school children in fully virtual or blended learning programs. The program will include remote learning with the help of trained and highly skilled tutors, educational activities, hot lunch, outdoor play, Jewish culture and lots of fun!

We have only 18 spots for September. Register now before we are full!

JKC will be open as of Thurs, Sept. 10 regardless of when public schools will open. From Sept. 10 begins, JKC hours are 9am until 2pm. Once school begins in- person or remote learning we will begin the extended care options (8:15-9am and 2-4pm).

Please note that JKC is open for September and October on a trial basis. We will then reassess and make any necessary revisions for November’s schedule and rates. Thank you for your understanding.

As the pandemic continues, we at JKC will be vigilant to keep the students and staff safe and will be carefully following all CDC guidelines. We will monitor symptoms of COVID-19. We will be practicing social distancing, as developmentally appropriate. We will ensure hygiene (including regular cleaning and disinfecting). We will communicate and train staff, parents, and students related to new expectations. We will ensure isolation in case of symptoms or confirmed cases onsite. We will maintain required staff to camper ratios in the event of staff illness. We will do everything in our power to keep everyone healthy and safe.

image1-(1).png We are currently accepting application forms for the 2020-21 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

One registration form per child is needed.

Full Name*

First Name Last Name

Hebrew Name

Age*

Birth Date*

Month Day Year

School*

Grade Entering*

Address*

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

Home Phone

Area Code Phone Number

Child's Cell Phone

Area Code Phone Number

Child's E-mail

Name of Sibling 1

First Name Last Name

Age of Sibling 1

Name of Sibling 2

First Name Last Name

Age of Sibling 2

Father's Name

First Name Last Name

Father's Religion

Father's Occupation

Father's Business Name

Father's Address

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

Father's E-mail

Father's cell

Area Code Phone Number

Father's Facebook

Mother's Name

First Name Last Name

Mother's Religion

Mother's Occupation

Mother's Business Name

Mother's Address

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

Mother's E-mail

Mother's Cell

Area Code Phone Number

Mother's Facebook

Is the mother of the child Jewish?*

Yes No

Is the father of the child Jewish?*

Yes No

Were there any conversions or adoptions in the family?*

Yes No

If yes, please describe:

Marital Status of Parents:*

Married Separated Divorced

If divorced - how long?

What goals do you have for your child attending Jewish Kids Club?*

Please share any other information you feel is important for Jewish Kids Club to be aware of. This can include exceptional behavior, concerns, particular activities, family relationships etc.

Comments

Emergency Contact 1*

First Name Last Name

Relation to Child*

Phone Number*

Area Code Phone Number

Business Phone

Area Code Phone Number

Emergency Contact 2*

First Name Last Name

Relation to Child*

Phone Number*

Area Code Phone Number

Business Phone

Area Code Phone Number

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.

Doctor's Name*

First Name Last Name

Doctor's Phone*

Area Code Phone Number

Doctor's Address*

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

Permission for Emergency Medical Treatment:*

As the parent(s) or legal guardian I/we authorize any adult acting on behalf of Jewish Kids Club to hospitalize or secure treatment for my child. I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Jewish Kids Club personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to attend all field trips and outings sponsored by Jewish Kids Club.

9:00am-2:00pm regular jkc hours

2:00pm- 4:00pm extended care

Monthly tuition rate for regular jkc hours 9am-2pm:

$700 for 5 days a week

$620 for 4 days a week

$575 for 3 days a week

$450 for 2 days a week

$400 for 1 day a week

My child will be joining regular JKC hours only on:*

Special selection for regular JKC hours: $600 per month -My child will be in blended learning and is in cohort (check one)

Group A Group B Group C and will be attending only on days that my child is not in school. (3 or 4 days a week)

Monthly tuition rates for extended care hours 2-4pm:

$250 for 5 days a week

$220 for 4 days a week

$190 for 3 days a week

$175 for 2 days a week

$150 for 1 day a week

Please circle one:

My child will need to be picked up from school for extended care hours. (If NOT in PS100 please include additional $100 fee for transportation.) My child will only be joining extended care hours on days that he/she is already at JKC for regular hours. My child will be dropped off at JKC for extended care hours.

Please select which days of the week your child will be joining extended care hours:

Special selection for extended hours: $210 per month - My child will be in blended learning and is in cohort (check one)

Group A Group B Group C and will be attending only on days that my child is not in school. (3 or 4 days a week)

Early care 8:15-9:00am:

$75 per month

For questions, comments or discounted rates, contact us at [email protected] .

Payment options: (Please check off one.)*

Pay by check on the first day of each month. Pay online now and we will charge the same card on the first day of every month. (You’ll be charged a small fee for credit card processing.)

Enter promo code:

In order to complete your child's registration:

- submit full payment for (at least) September

- email updated health form to [email protected]

- wait for confirmation that your child is accepted

If you have any questions or concerns, feel free to contact us:
718-764-3544 • [email protected] • [email protected]

Commitment*

I understand that by submitting this form I am committing to pay the above outlined tuition fees.

Name*

First Name Last Name

Initials*

Date*

Month Day Year

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Amount to charge my card today

$

Total

$0.00

To apply for a scholarship, please click here

Student Information

Father's Information

Mother's Information

Confidential

Other

Emergency File

Tuition Agreement

Secure Online Payment

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