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Troy Jewish Community Religious School 2019-2020 Student Enrollment and Commitment Form

Please complete the following form by August 12, 2019.
*PLEASE note the additional Student Computer Loan Agreement Form at the end of this document.

One set of forms can be used for all children in your family.  Please note that providing electronic initials as a signature in Parts II and III will meet the signature requirement.
Berith Sholom
Beth El
Sunday 9 am - noon
Parent/Guardian #1
Parent/Guardian #2

Education History

Emergency Medical Information

Sunday 9 am - noon
Parent/Guardian #1
Parent/Guardian #2

Education History

Emergency Medical Information

Sunday 9 am - noon
Parent/Guardian #1
Parent/Guardian #2

Education History

Emergency Medical Information

Parent #1 Contact Information

Parent #2 Contact Information

I hereby give my permission for all of the following:

For my child to participate in an outing with TJCRS;
For the administration, teachers, and aides, as applicable, to provide necessary transportation for the outing;
To render first aid as needed;
For a physician, selected by the adult in charge, to hospitalize, secure proper anesthesia, injection or other medical treatment, as needed;
To hold the above names organization and it administration, teachers, and aides blameless for any accidents that might occur during the outing except for clear acts of negligence or non-adherence to TJCRS.

July 1, 2019 - June 30, 2020

Congregation Berith Sholom is home to the Troy Jewish Community Religious School. TJCRS is in session throughout the school year on Sunday mornings for all students grades K through 7. Please note that all families must be in good standing (current financial commitment and TJCRS fees) to enroll student(s) for the 2017-18 academic year. Contact berithsholomprez@gmail.com for current financial status and to make arrangements for any past due balance.
TJCRS fees:
1. Tuition of $300 per student
2. Supply/Computer fee of $30 per student

These fees will be included on your commitment statement from Berith Sholom. You will be charged monthly or quarterly based upon how you have chosen to pay your commitment.

Please note: If a member has difficulty with the regular fees, contact the President of Berith Sholom ( berithsholomprez@gmail.com ) to discuss a possible partial scholarship. This is reevaluated each year. All financial information is held in strict confidence.

My/Our commitment to Congregation Berith Sholom for the enrollment of my/our child(ren) in TJCRS, Grades K-7, on Sundays for the 2019/20 year is:
1. Tuition of $300 per student ( $300 x___) = ______
2. Supply/Computer fee of $30 per student ($30 x___) = __________


By providing name and electronic initials or signature below, I am agreeing to both the permission slip and financial agreement commitment form:

While at TJCRS students will conduct themselves in a manner that is appropriate to a holy place and the study of Torah. Students will follow these five rules:

1. Speak and behave respectfully toward others;
2. Come to class on time, prepared with books and other materials;
3. Follow direction of teacher and other persons of authority;
4. Follow class rules.

Parents, teachers, rabbis, and directors will work together as partners.

• Parents will encourage positive attitudes toward study and behavior;
• Teachers will encourage positive behavior through teaching and discipline in the classroom;
• Directors and rabbi will support and maintain the enforcement of discipline within the school.

If a student violates this established brit limmud, the teacher or the directors will take corrective action with discretion and good judgment in the following manner:

1. The teacher will remind the student of the rules.
2. If inappropriate behavior persists, the student will be asked to leave the class and meet with the Principal
3. If inappropriate behavior persists, the student will meet with a Principal and parents(s) will be contacted.
4. If the situation is not resolved, the Principal will have the right to give the student an in-house suspension for a day. During the suspension the student will be expected to complete assigned work. The expectation is that the child will return to class as a productive and positive member of the class.
5. If inappropriate behavior continues, the student will be given a second in-house suspension. The expectation continues to be that the child will return to class as a productive and positive class member.
6. In the unlikely event that the problem persists, the Principal will have the option to pursue indefinite out-of-school suspension.

If the student violates the brit limmud in such an extreme fashion that the Principal judges that is would be inappropriate to follow the procedure set forth above, the Principal may assign a penalty in accordance with the violation, including expulsion from TJCRS.

TJCRS will be issuing a computer for in school use to each student for 2019-20. The student will be assigned a computer number and will be responsible to take good care of the computer equipment. The student will use the computer for educational purposes only for use with the Shalomlearning curriculum. Unethical use of the Internet, email, or any other media will result in student forfeiture of computer use. Configuration of the hardware equipment and all accompanying software may not be altered, nor can software be copied to or from the computer, or installed on the computer. Parents/guardians accept financial responsibility for cost related to damage due to purposeful action or gross negligence. Parents/guardians are required to pay a non---refundable security deposit of $30. The payment must be made prior to the student receiving the laptop. This student computer loan agreement, which is signed by the parent/guardian, student and staff member of the school, will be kept on file at the school. We, the undersigned parent/guardian, agree to assume full responsibility for the proper care and educational use of the computer equipment described in this document. Student Name (print) _______________________________________

Parent/Guardian Signature

Account Details

Enter your name and e-mail address for your confirmation:

Payment Information

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