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2024-2025 Religious School Registration

Section A: Family Contact Information

Section B: Emergency Contact Information
Section C: Student Enrollment Information
Student 1 Information
MKT MEMBERS ONLY
NON-MEMBERS ONLY
NON-MEMBERS ONLY
Parental Consent/Medical Release

By signing my name below, my child have permission to participate in the Religious School at Midbar Kodesh Temple. I hereby authorize the Religious Director, or person designated by the Religious Director, to obtain emergency medical care for my child in the event such care is indicated. I give my permission for my child to receive emergency medical care by any nurse, doctor, paramedic or member of a medical staff of a hospital licensed by the State of Nevada. I understand that every effort will be made to notify a parent/guardian prior to treatment.

I certify that my child is in good physical health. They have my permission to participate in all activities that are part of the regular religious school program. 

By typing my name, I confirm I have read, understand and agree to the above.
Media Release

From time to time your child’s photo may be taken in our classrooms or special events.  We use these photos in the synagogue newsletters, on our synagogue website as well as our Social Media groups and other publicity materials.

Offsite Activity/ Field-trip Release

My child has permission to participate in off-site group activities with their MKT Religious School Program group. Additionally, my child has permission to go by private car with MKT Religious School Program group to any off-site activity.

Please upload a current picture of your child here. 
Student 2 Information
MKT MEMBERS ONLY
NON-MEMBERS ONLY
NON-MEMBERS ONLY
Parental Consent/ Medical Release

By signing my name below, my child have permission to participate in the Religious School at Midbar Kodesh Temple. I hereby authorize the Religious Director, or person designated by the Religious Director, to obtain emergency medical care for my child in the event such care is indicated. I give my permission for my child to receive emergency medical care by any nurse, doctor, paramedic or member of a medical staff of a hospital licensed by the State of Nevada. I understand that every effort will be made to notify a parent/guardian prior to treatment.

I certify that my child is in good physical health. They have my permission to participate in all activities that are part of the regular religious school program. 

By typing my name, I confirm I have read, understand and agree to the above.
Media Release

From time to time your child’s photo may be taken in our classrooms or special events.  We use these photos in the synagogue newsletters, on our synagogue website as well as our Social Media groups and other publicity materials.

Offsite Activity/ Field-trip Release

My child has permission to participate in off-site group activities with their MKT Religious School Program group. Additionally, my child has permission to go by private car with MKT Religious School Program group to any off-site activity.

Please upload a current picture of your child here. 
Student 3 Information
MKT MEMBERS ONLY
NON-MEMBERS ONLY
NON-MEMBERS ONLY
Parent Consent/ Medical Release

By signing my name below, my child have permission to participate in the Religious School at Midbar Kodesh Temple. I hereby authorize the Religious Director, or person designated by the Religious Director, to obtain emergency medical care for my child in the event such care is indicated. I give my permission for my child to receive emergency medical care by any nurse, doctor, paramedic or member of a medical staff of a hospital licensed by the State of Nevada. I understand that every effort will be made to notify a parent/guardian prior to treatment.

I certify that my child is in good physical health. They have my permission to participate in all activities that are part of the regular religious school program. 

By typing my name, I confirm I have read, understand and agree to the above.
Media Release

From time to time your child’s photo may be taken in our classrooms or special events.  We use these photos in the synagogue newsletters, on our synagogue website as well as our Social Media groups and other publicity materials.

Offsite Activity/ Field-trip Release

My child has permission to participate in off-site group activities with their MKT Religious School Program group. Additionally, my child has permission to go by private car with MKT Religious School Program group to any off-site activity.

Please upload a current picture of your child here. 
Mon, December 2 2024 1 Kislev 5785