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Open House 2024
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Tots Academy Registration 2024-2025
Please verify reCaptcha before submitting the form.
Please complete this registration form to enroll your child (with accompanying adult) in this class. Open to the community! Tots Academy meets monthly on select Sunday morning from 9:30-11:00am. An accompanying adult is required.
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Please choose the number of children enrolling
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Child's First Name
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Child's Last Name
Child's Date of Birth (MM/DD/YYYY)
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Temple Shalom Member?
Please Select One
Yes
No
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Number of Children Enrolled
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2
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Temple Shalom Member Child: $100/child
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Non-Member Child: $180/child
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First Name of Adult Attending
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Last Name of Adult Attending
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Email
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Mobile
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Street Address
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City
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State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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Zip Code
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Temple Shalom Member?
Please Select One
YES
NO
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Please tell us how you heard of this program.
I am a Temple Shalom member.
Temple Shalom Facebook Page/Groups
Temple Shalom Website
Temple Shalom Newsletter
Temple Shalom Religious School Newsletter
Friend/Family Member
Other Facebook Page/Group
Texas Jewish Post
*
Photo Release--I consent to the use of images of anyone in our party as described below.
Please Select One
YES
NO
Privacy and Use of Images: Families may be photographed or videotaped as they participate in Temple activities, or they may be recorded in Temple Shalom video stream programs. On occasion, these images, and the identity of the persons depicted, may be used by Temple Shalom for educational, instructional, development and/or informational purposes in print, internet and digital media, including in news releases (e.g, Texas Jewish Post) and/or printed publications or materials, electronic publications, or websites. Temple Shalom will not sell images of Temple Shalom members or non-members or their families to third parties, and it will not use their images for promotional or advertising purposes that do not concern Temple Shalom and its programs.
Tots Academy Total Fee
Wed, August 21 2024
17 Av 5784
Wed, August 21 2024 17 Av 5784