REGISTRATION FORM

Membership Fees	$625 - one child/ yearly membership
for 5770	$25 deduction - DJC Members- per child
[2009/2010]:	$25 deduction - Early Bird -per family
	(partial or full payment by June 26/09)

CLASSES BEGIN SEPTEMBER 10, 2009

elcome to our on-line Jewish Studies payment process. There are two steps in this process. First, please complete the registration form below. Provide as much information as you possibly can. Part of this on-line form also includes an opportunity to participate in the voluntary portion of the on-going life of the DJC. Take a little time to help all of us by specifying these parts of our program you are willing to support with your time.

*If you wish to submit the fees with post dated installments, you may download the registration form and mail in the application with all post dated cheques to: DJC Children’s Jewish Studies Program, 283 Danforth Avenue, Ste 125, Toronto, ON M4K 1N2

PDF version: DJC_JS_Registration_2009.10 or Word version: DJC_JS_Registration_2009.10

Thank you.

1	Parent's Name(s)
	*Given Name:
	*Family Name:
	*E-mail:
	*Telephone:
		home	work	ext	cell

2
	Given Name:
	Family Name:
	E-mail:
	Telephone:
		home	work	ext	cell

Children to be registered (all information required for each student)
Name		Date of Birth	mm/dd/yy	Gender:	F M
	Name of School		Grade Next Year		Health Card #
Name		Date of Birth	mm/dd/yy	Gender:	F M
	Name of School		Grade Next Year		Health Card #
Name		Date of Birth	mm/dd/yy	Gender:	F M
	Name of School		Grade Next Year		Health Card #
Name		Date of Birth	mm/dd/yy	Gender:	F M
	Name of School		Grade Next Year		Health Card #
Name		Date of Birth	mm/dd/yy	Gender:	F M
	Name of School		Grade Next Year		Health Card #

Payment of Time
Volunteers are the very lifeblood of the DJC JS Program. We simply could not exist were it not for the dedication and devotion of a handful of members. We need your help. A few hours of your time could make a world of difference to us…and you. Use the appropriate number (1 or 2) to indicate which parent is volunteering to help.
High Holidays: Children’s Services		Committees
1 2	Help organize R.H. children’s service	1 2	Education Committee
1 2	Help develop Yom Kippur children’s service	1 2	Volunteer Coordination Committee
1 2	Have your child read at this year’s services
Children's Education		Festivals/Celebrations
1 2	Library	1 2	Purim
1 2	Curriculum	1 2	Passover
1 2	Assist in Class	1 2	Chanukah
1 2	Class Parent	1 2	Sukkot
1 2	Read Hebrew	1 2	Set-up / Clean-up
General		Skills to benefit children
1 2	Special events	1 2	Arts (Drama/Dance/Music/Singing/ Painting)
1 2	Set-up / Clean up	1 2	Sciences
		Other Please indicate parent 1 or 2

Please let us know added skills — at home or at your workplace — as that can help us establish a resource base.
Also, Please list any specific concerns, ie: learning requirements, allergies or food restrictions your child(ren) may have:

Emergency Contacts: (Please list two contacts to be called other than parents)
*Name 1: Phone:
*Name 2: Phone:

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