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J-FLEx 2020-21 Registration
Please verify reCaptcha before submitting the form.
The official start of J-FLEx will begin with
J-FLEx@Home
on
Sunday, October 11, 2020.
J-FLEx@Gates of Prayer
will begin the following
Sunday, October 18, 2020 from 9:30 - 10:30 AM
. Our starting date for our Sunday morning 8th/9th Grade program, led by Rabbi Erdheim, will be
November 8, 2020 at 10:30 AM
. For those 8th/9th Graders unable to attend in-person, there will be a virtual option beginning
Sunday, October 18, 2020 at 9:30 AM
.
Join our
Facebook page
for up to the minute information.
Because of the uncertain nature of our J-FLEx year, we will not be charging our typical tuition of $399.00 Instead, we would ask that you make a donation to our Educational programming if you are able.
J-FLEx Student (J-FLExer) Name (#1)
J-FLExer (#1) Birth Date
J-FLExer (#1) Current Secular School Grade 2020-2021
J-FLExer (#1) Level
Pre-K
K/1st
2nd/3rd
4th/5th
6th/7th
8th/9th Thursday Night Sessions
8th/9th Sunday Virtual Option
Level expected to participate in J-FLEx
J-FLExer # 1 will most likely participate.....
J-FLEx@Home
J-FLEx @Gates of Prayer ( outside when feasible with social distancing and mask wearing)
J-FLEx @Home & Gates of Prayer
J-FLEx @Gates of Prayer 8th/9th Graders Only (In-person Sundays 10:30 AM )
J-FLEx@Home 8th/9th Graders ( Sundays 9:30 AM )
J-FLEx Student (J-FLExer) Name (#2)
J-FLExer (#2) Birth Date
J-FLExer (#2) Current Secular School Grade 2020-2021
J-FLEx (#2) Level
.
Pre/K
K/1st
2nd/3rd
4th/5th
6th/7th
8th/9th
Level expected to participate in J-FLEx
J-FLExer # 2 will most likely participate.....
N/A
J-FLEx@Home
J-FLEx @Gates of Prayer ( outside when feasible with social distancing and mask wearing)
J-FLEx @Home & Gates of Prayer
J-FLEx@Home 8th/9th Graders - Sunday 9:30 AM
J-FLEx@Gates of Prayer 8th/9th Grade Thursday at 6:30 PM
Parent's Name (A)
Parent's E-mail Address (A)
Parent's Mobile Number (A)
Parent's Name (B)
Parent's E-mail Address (B)
Parent's Mobile Number (B)
Primary Address
Home Phone Number
Does your child spend time in two homes?
No. Our child spends all his/her time at the primary address.
Yes. Our child will spend time at two homes throughout the year.
Secondary Address
I would like to receive text messages regarding J-FLEx events and closings.
Yes - Parent (A)
No - Parent (A)
Yes - Parent (B)
No - Parent (B)
No more than one text message per week on average
Member of Congregation Gates of Prayer
Yes
No- I/we are in the process of joining Congregation Gates of Prayer.
In addition to Parents A & B, I would like the following to receive all the information regarding the J-FLExers registered on this application.
Please include name, E-mail address, mobile number and relationship to J-FLExers.
J-FLExer (#1) Interests:
Jewish Cooking
Jewish Yoga
Technology
Art
Music
Israel
Sports
Drama
Hebrew
Photography
Journalism
Dance
Debate
C.I.T. (Counselor in Training Post Bar/Bat Mitzvah only)
Other J-FLExer (#1) Interests:
J-FLExer (#2) Interests:
Jewish Cooking
Jewish Yoga
Technology
Art
Music
Israel
Sports
Drama
Hebrew
Photography
Journalism
Dance
Debate
C.I.T. (Counselor in Training - Post Bar/Bat Mitzvah only)
Other J-FLExer (#2) Interests:
Does your child (#1) have any documented learning challenges? If so, please explain:
How can we better serve your child (#1) with his/her/zir learning challenges? Please share any tactics or advice you or other adults have used in the past.
Does your child (#2) have any documented learning challenges? If so, please explain:
How can we better serve your child (#2) with his/her/zir learning challenges? Please share any tactics or advice you or other adults have used in the past.
Does your child (#1) have any medical issues for which we need to be aware, including a positive Covid-19 diagnoses? How can we better serve your child with his/her/zir medical needs?
Does your child (#2) have any medical issues for which we need to be aware, including a positive Covid-19 diagnoses? How can we better serve your child with his/her/zir medical needs?
Non Parent Emergency Contact Information
(Please include name, phone number and relationship to child) Please inform this contact that they are listed as your child's non-parent emergency contact.
J-FLEx Parent (A) Partnership Opportunities
Drive for Field Trips
Photographer
Set Up & Monitor Kehillah Kafe (7th-Conf.)
Substitute
Arts/Crafts
Technology
Cooking
J-FLEx Specialist (Various Sundays)
Yoga Instructor
I would be interested in helping out in the following ways. For more details contact Phil Gaethe at 885-2600 or via E-mail at educator@gatesofprayer.org
I would like to lead a J-FLEx Experience on......
Please describe any expertise (cooking, music, art, technology, etc.) you may have that could be utilized in a J-FLEx Sunday morning or weeknight Experience.
J-FLEx Parent (B) Partnership Opportunities
Drive for Field Trips
Photographer
J-FLEx Specialist (Various Sundays)
Set Up & Monitor Kehillah Kafe (7th-Conf.)
Substitute
Yoga Instructor
I would be interested in helping out in the following ways. For more details contact Phil Gaethe at 885-2600 or via E-mail at educator@gatesofprayer.org
I would like to lead a J-FLEx Experience on......
Please describe any expertise (cooking, music, art, technology, etc.) you may have that could be utilized in a J-FLEx Sunday morning or weeknight Experience.
Agreement for Limited COVID-19 Release
1. I am aware that there are risks associated with my child contracting COVID-19 by participating in J-FLEx programming during the COVID-19 pandemic. There are risks associated with entering the facility, being on synagogue grounds and/or being in contact with CGoP/J-FLEx employees during the COVID-19 pandemic.
2. On behalf of myself and/or my child, I knowingly assume all possible COVID-19 exposure risks, both known and unknown, relating to my child's presence in or outside the facility or receiving services from CGoP/J-FLEx.
3. I hereby release, waive, relinquish, and discharge the CGoP/J-FLEx, along with its owners, officers, directors, managers, employees, from any and all claims, demands, liabilities, rights, damages, expenses, and causes of action in any way related to the COVID-19 pandemic.
4. My child will not participate in J-FLEx@Gates of Prayer if he/she/zie has been exposed to Covid-19 within 14 days of any J-FLEx program. This does not exclude my child from participating in J-FLEx@Home.
5. My child will not participate in J-FLEx@Gates of Prayer if he/she/zie is feeling unwell, including, but not limited to, vomiting, fever, coughing, soar throat. body aches, etc. This does not exclude my child from participating in J-FLEx@Home.
By checking this box I accept the Covid-19 statements listed on this registration form.
By checking this box I accept the Covid-19 statements listed on this registration form.
Because of the uncertain nature of our J-FLEx year, we will not be charging our typical tuition of $399.00 Instead, we would ask that you make a donation to our Educational programming if you are able.
Thu, April 25 2024 17 Nisan 5784