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Mitzvah Secular Sunday School - Enrollment Form

Referral Information


Student Information

Please make sure to include: Severity, type of reaction, and methods of exposure to avoid (ex: inhaled, ingested, physical contact).
Please specify if each medication is taken at home or carried with them.

Emergency Contacts

Primary Emergency Contact
It is strongly recommended that this be the student's legal guardian.
Secondary Emergency Contact
Tertiary Emergency Contact

Tuition Information

This information is used to calculate the total tuition for which you will be invoiced.

Tuition Rates*

$495* per student enrolled in:
• Kitah Keff (Pre-K)
 
$995* per student enrolled in:
• Kitah Gan (K & 1st grade)
• Kitah Alef (2nd & 3rd grade)
• Kitah Bet (4th & 5th grade)
• Kitah Gimel (6th & 7th grade
$1,195* per student enrolled in:
• B Mitzvah Program
No student turned away: SJC will never turn away families who are unable to pay the suggested amount.
Our Treasurer will email you prior to invoicing.
Give the gift of educationAny additional funds donated beyond the suggested amount will be used to fund scholarships for students who cannot afford the full suggested amount, but wish to enroll/remain enrolled.
This let's us know to keep an eye out for a check from your employer.

Consents

I/We give permission for my/our child(ren) to receive basic first aid while attending Mitzvah Secular Sunday School. I/We have informed Mitzvah Secular Sunday School staff of all my/our child(ren)'s known medical conditions and medications. I/We consent to emergency medical treatment being provided to my/our child(ren) by a licensed emergency medical team (including transport by ambulance or other emergency vehicle) when I/we cannot be reached and it is deemed immediately necessary by Mitzvah Secular Sunday School staff.
I/We give permission for my/our child(ren) to attend Mitzvah Secular Sunday School field trips, and understand that transport may be provided via private vehicles (of staff, parents of existing students, or chaperones), public transit (metro bus, streetcar or light rail) or walking. Parents will always receive at least two weeks advance notice of field trips.
I/We authorize Mitzvah Secular Sunday School to take and store photographs or video of my child(ren) while enrolled for use on the Secular Jewish Circle of Puget Sound official website and/or marketing materials.

Attestations

Mon, 30 June 2025