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J-FLEx 2022-23 Registration
Please verify reCaptcha before submitting the form.
J-FLEx will officially start on Sunday, September 18, 2022
from 9:30 AM-11:30 AM.
Join our
Facebook page
for up to the minute information.
Learn more about Gates of Camp Program
HERE
For third or fourth child, please fill out additional form. Only information regarding the third/fourth child is needed on additional form.
J-FLEx Student (J-FLExer) Name (#1)
J-FLExer (#1) Birth Date
J-FLExer (#1) Current Secular School Grade 2022-2023
J-FLExer (#1) Level
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
Level expected to participate in
J-FLEx for 2022-23 year.
J-FLEx Student (J-FLExer) Name (#2)
J-FLExer (#2) Birth Date
J-FLExer (#2) Current Secular School Grade 2022-2023
J-FLExer (#2) Level
N/A
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
Level expected to participate in
J-FLEx for 2022-23 year.
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
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.
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 if he/she/zie has been exposed to Covid-19 within 14 days of any J-FLEx program. .
5. My child will not participate in J-FLEx if he/she/zie is feeling unwell, including, but not limited to, vomiting, fever, coughing, soar throat. body aches, etc.
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.
Payment details
Pay full amount at time of registration (399.00 per child)
Pay in monthly installments (399.00 per child)
Please choose a payment option. Payment instructions will appear after clicking "
submit
" below.
SPECIAL DISCOUNTS on J-FLEx registration
Pay in Full by September 18, 2022 - Waive 3% Credit Card Fee (
Please pay through the
CGoP
Office 504-885-2600)
Pay in Full by September 18, 2022 - 3% Discount on All Other Forms of Payment such as check/cash.
At Gates of Prayer we believe that all children should have the opportunity for a quality Jewish educational experience. If obstacles are hindering your ability to register your children, please contact Rabbi Gerber or Temple Educator Phil Gaethe, for possible assistance options.
Wed, November 6 2024 5 Cheshvan 5785