Welcome to Religious School Registration!

You must be a member to register your children for school.

Pre-K/K: $325
1st-3rd: $450
4th, 5th: $575
6th-9th: $450
10th: $575

Please contact the Micah Office if you have any questions at 615-377-9799.

FULL PAYMENT is required on the final page of your child's registration. If you have a child in Cohort, you will be billed separately for this class. Each child must be registered individually.
* Indicates a required field.

Parent 1 First Name

First Name

Last Name

Parent 1 Last Name

Parent 1 Email

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Child First Name

Child Last Name

Secular School

Which secular school does your child attend?

Secular School Grade Level

Please choose which grade your child attends in secular school, this may differ than their Religious School grade level.

Describe any situations that could affect your child's attendance

Describe any physical or learning concerns that might affect the student's performance and/or participation

Please list all allergies that your child has (food, medicine, etc)

Please list any medications that your child will be taking during the Religious School day

Additional Info

Please give any additional information about your child that helps our understanding of how to provide the best possible experience for him/her.

What are your goals for your child's Jewish education at Micah?

Please accept the following releases for your child's participation.

PHOTO RELEASE: I consent to have my child(ren) photographed, videotaped, and/or audio taped by Congregation Micah as well as the use of creative works produced by my child(ren) for means of public display for promotional purposes. I release and hold harmless Congregation Micah of any and all claims or liability that shall arise by the use of my child's creative work(s), photograph, likeness or voice. I agree that no monies or other consideration in any form will become due because of my child's participation in any of the above activities.

True

False

Please accept the following releases for your child's participation.

RELIGIOUS SCHOOL AND FIELD TRIP RELEASE: I, the parent/guardian of this minor child, hereby give permission for the minor child to attend Congregation Micah Religious School including any program/activity held at the school or sponsored field trip. I hereby do release and hold harmless Congregation Micah and its trustees, agents, officers, servants, and employees against loss (including reasonable attorney fees) from any and all claims, or causes of action of any kind or nature that may be brought by or on behalf of the said minor child or by me arising out of any and all known or unknown, foreseen and unforeseen bodily or personal injuries, damages to property and consequences thereof which may be sustained by the minor or by me arising out of or in connection with the minor child's participation at school or on any field trip, except such liability or claim of liability as may result from gross negligence on the part of Congregation Micah. If the minor child should suffer an injury or illness at school during a field trip, I authorize the employees of Congregation Micah to use their discretion to transport or to have the minor child transported to any medical facility and hereby give consent in my absence to have the minor child treated at any medical facility, and I take full responsibility for that action.

True

False

Religious School Grade Level