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PS 295 - After School and Ha’Geemnasia Registration Winter 2018-19
AS - Registration Information for PS295
Are you a CBE temple member?
Temple Member?
Yes
No
Student First Name
*
Student Last Name
*
Parent Email Address
*
Grade
*
- select -
Pre - K
K
1st
2nd
3rd
4th
5th
6th
Gender
*
Street Address
*
City
*
State
*
- select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
United States Minor Outlying Islands
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal Code
*
Registration Fees
Sibling Discount instruction:
.
If you are registering more than one child within the same household, you are eligible to receive a 5% discount on After School care for all children after you have paid the full price of tuition for the first child. In order to receive this discount, you should fill out the same form and email Lisa Wolf at lwolf@cbebk.org for a 5% refund after payment has been received. If needed, payment can be processed manually if you prefer to pay the discounted amount instead of waiting for a refund. Please contact Lisa Wolf at lwolf@cbebk.org for this option.
CBE KIDS: # of Days Attending
One Full Day
-
$ 505.00
Two Full Days
-
$ 785.00
Three Full Days
-
$ 1,020.00
Four Full Days
-
$ 1,155.00
Five Full Days
-
$ 1,270.00
- none -
*PLEASE NOTE: If you are registering to both After School AND Ha'Geemnasia you need to choose one of the After School + Ha'Geemnasia options above AND one of the Ha'Geemnasia options below. *If you are registering just for Ha'Geemnasia please select only from the options below. *If you are not sure please email Lisa Wolf (After School) lwolf@cbebk.org or Alex Ben-Abba (Ha'Geemnasia) hageemnasia@cbebk.org
CBE KIDS: # of Single Classes Attending
1 Class
- $ 275.00
2 Classes
- $ 545.00
3 Classes
- $ 820.00
4 classes
- $ 1,095.00
HAGEEMNASIA: # of Days Attending
- select -
Tuesday - $ 760.00
Friday - $ 760.00
Tuesday & Friday - $ 1,230.00
PLEASE NOTE: Ha'Geemnasia hours are - K-1st 3:45-5:45 PM 2nd-3rd 3:45-5:45 PM
Additional Fee Courses
Group Piano
- $ 50.00
Ice Skating
- $ 225.00
Please reconfirm your selection in the choices below.
Registration Fee
*
Registration Fee
- $ 25.00
Registration Fee Hebrew Programming
- $ 25.00
*If you are registering for BOTH After School and Ha'Geemnasia, please check both options above. *A 1.5 percent convenience fee will be added to your total.
Convenience Fee %
Total Fee(s)
Credit Card Information
Card Type
- select -
Visa
MasterCard
Amex
Discover
Card Number
*
Security Code
*
Expiration Date
*
-month-
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
-year-
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
My billing address is the same as above
Billing Name and Address
Billing First Name
*
Billing Middle Name
Billing Last Name
*
Street Address
*
City
*
Country
*
- select -
United States
State/Province
*
- none -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
United States Minor Outlying Islands
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal Code
*
AS Course Selection - PS 295 Winter 18-19
Winter # of Days
- none -
1
2
3
4
5
Winter Term Days
Monday
Tuesday
Wednesday
Thursday
Friday
Winter Term Single Class
Monday
Tuesday
Wednesday
Thursday
Friday
PS295 - Winter 18-19 Monday 1st Choice
- none -
Circus Arts grades 1-2
Magic grades 3-5
Basketball 2nd-5th
Journey to Mars 1st-2nd
Open Studio 3rd-5th
Fractured Fairytales 1st-2nd
Advanced Video Production 3rd-5th
Circus Arts grades Pre K-K
PS295 - Winter 18-19 Monday 2nd Choice
- none -
Circus Arts grades 1-2
Magic grades 3-5
Basketball 2nd-5th
Journey to Mars 1st-2nd
Open Studio 3rd-5th
Fractured Fairytales 1st-2nd
Advanced Video Production 3rd-5th
Circus Arts grades Pre K-K
PS295 - Winter 18-19 Tuesday 1st Choice
- none -
Ninja Challenge grades 1st-2nd
Sewing/Quiltmaking grades 2-5
Gymnastics grades 2-5
Puppetry - Winter Wonderland grades Pre K-K
Kickball grades 2-5
Advanced Puppetry 2nd-5th
Puppetry-Winter Wonderland grades K-1
PS295 - Winter 18-19 Tuesday 2nd Choice
- none -
Ninja Challenge grades 1st-2nd
Sewing/Quiltmaking grades 2-5
Gymnastics grades 2-5
Puppetry - Winter Wonderland grades Pre K-K
Kickball grades 2-5
Advanced Puppetry 2nd-5th
Puppetry-Winter Wonderland grades K-1
PS295 - Winter 18-19 Wednesday 1st Choice
- none -
Instructional Swim grades 2-5
Kids Cook! grades grades 2-5
Tennis K-1st
Tennis 2nd-5th
Comics and Illustrations 2nd-5th
A Journey Through Harry Potter's World of Magic 3rd-5th
Red, Blue and Glue - Mixed Media Pre K-1st
World Drumming Pre K-K
World Drumming 1st-2nd
PS295 - Winter 18-19 Wednesday 2nd Choice
- none -
Instructional Swim grades 2-5
Kids Cook! grades grades 2-5
Tennis K-1st
Tennis 2nd-5th
Comics and Illustrations 2nd-5th
A Journey Through Harry Potter's World of Magic 3rd-5th
Red, Blue and Glue - Mixed Media Pre K-1st
World Drumming Pre K-K
World Drumming 1st-2nd
PS295 - Winter 18-19 Thursday 1st Choice
- none -
Capoeira grades Pre K-1
Capoeira grades 2-5
Chess 2nd-5th
Soccer 2nd-5th
Soccer Pre K-1st
World Collage Pre K-1st
World Collage 2nd-5th
Destroy and Construct 2nd-5th
PS295 - Winter 18-19 Thursday 2nd Choice
- none -
Capoeira grades Pre K-1
Capoeira grades 2-5
Chess 2nd-5th
Soccer 2nd-5th
Soccer Pre K-1st
World Collage Pre K-1st
World Collage 2nd-5th
Destroy and Construct 2nd-5th
PS295 - Winter 18-19 Friday 1st Choice
- none -
Group Piano grades 1-2 (additional fee)
Group Piano grades 3-5 (additional fee)
Ice Skating grades 2-5 (additional fee)
Intermediate Swim grades 2-5
Jewelry Making 2nd-5th
Kids Cook! Grades K-5
Sports Sampler grades 2-5
Sports Sampler grades prek-1
PS295 - Winter 18-19 Friday 2nd Choice
- none -
Group Piano grades 1-2 (additional fee)
Group Piano grades 3-5 (additional fee)
Ice Skating grades 2-5 (additional fee)
Intermediate Swim grades 2-5
Jewelry Making 2nd-5th
Kids Cook! Grades K-5
Sports Sampler grades 2-5
Sports Sampler grades prek-1
AS - Pick Up Person
The following person(s) is authorized to pick my child up from After School.
Pick Up Contact 1 - Name
Pick Up Contact 1 - Cell Phone
Pick Up Contact 2 - Name
Pick Up Contact 2 - Cell Phone
Pick Up Contact 3 - Name
Pick Up Contact 3 - Cell Phone:
End of the day dismissal options
*
- select -
Can go home on their own
Can leave with Sibling that is allowed to leave on their own
Will be picked up at the end of the day by an adult listed on the authorized pick up list
AS - Parents/Guardians
Parent/Guardian 1 Name
*
Parent/Guardian 1 Primary email
*
Parent/Guardian 1 Home Phone
*
Parent/Guardian 1 Work Phone
Parent/Guardian 1 Cell Phone
*
Parent/Guardian 2 Name
Parent/Guardian 2 Primary email
Parent/Guardian 2 Home Phone
Parent/Guardian 2 Work Phone
Parent/Guardian 2 Cell Phone
AS - Emergency Information
Allergies?
*
Yes
No
If yes, please specify allergies and action to take:
Medication?
*
Yes
No
If yes, please specify:
AS - Signature
Please type your full name to sign the form and agree to the terms and conditions.
Electronic Signature
*