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CJL Kindergarten Registration 2021-22

IMPORTANT: Please complete one form per child.  Thank you!

In the event that we cannot reach a parent(guardian), please provide the name of an emergency contact

Please indicate this person's relationship to child.

We will do our best to honor your request!

PHOTO/VIDEO CONSENT RELEASE: As the parent(s) or guardian(s) of minor child/children enrolled in the Temple Israel Center for Jewish Learning, I/We will give consent, without further consideration or compensation, to allow Temple Israel of Northern Westchester (hereinafter TINW) and or their duly appointed representative or any person(s) acting with their permission to record and publish the likeness or image (full or in part) of my child/children, in all forms including but not limited to still, video or electronic photographic formats with or without sound. These photographic images may be used for whatever lawful purpose they may desire. If photographic material is published, TINW will take precautionary steps to provide minimal identifying information. No student’s name, mailing address, telephone number or e-mail address will be on or published with any photographic image. Further, I/We release TINW and their duly appointed representative(s) and any person acting with their permission from any and all liability that may arise from the use of these photographic materials. This consent and release shall remain in full force and effect until withdrawn by me/us in writing.
Thu, June 30 2022 1 Tammuz 5782