Thank you for enrolling in the VBS Etz Chaim Learning Center (ECLC) Hebrew School! Please complete this form if you are new to the ECLC and to VBS as a member. If you are requesting financial aid, please complete the confidential
special dues form and our Membership Manager will follow up with you. If you have any questions about the ECLC, please contact the ECLC office at 818-530-4043.
* What type of membership are you registering for?Please Select One Family Membership (2 adults) Singe Membership (1 adult)
* How many children are you enrolling in the ECLC?Please Select One 1 2 3 4
Student 1 Information
* What class is the student registering for? Please Select One Kindergarten (Gan) - $1,270, Sundays 9:30-11:45am 1st Grade (Alef) - $1,270, Sundays 9:30-11:45am 2nd Grade (Bet) - $1,780, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am 3rd Grade (Gimmel) - $1,780, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am 4th (Dalet) Grade (Academy options below) 5th (Hei) Grade (Academy options below) 6th (Vav) Grade (Academy options below) 7th Grade (Zayin), $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am
* 4th (Dalet) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 5th (Hei) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 6th (Vav) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options
Student 2 Information
* What class is the student registering for? Please Select One Kindergarten (Gan) - $1270, Sundays 9:30-11:45am 1st Grade (Alef) - $1,270, Sundays 9:30-11:45am 2nd Grade (Bet) - $1,780, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am 3rd Grade (Gimmel) - $1,780, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am 4th (Dalet) Grade (Academy options below) 5th (Hei) Grade (Academy options below) 6th (Vav) Grade (Academy options below) 7th Grade (Zayin) - $2,300 Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am
* 4th (Dalet) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 5th (Hei) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300 Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 6th (Vav) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options
Student 3 Information
* What class is the student registering for? Please Select One Kindergarten (Gan) - $1,270, Sundays 9:30-11:45am 1st Grade (Alef) - $1,270, Sundays 9:30-11:45am 2nd Grade (Bet) - $1,780, Tuesdays 4:00-6:15pm and... 3rd Grade (Gimmel) - $1,780, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am 4th (Dalet) Grade (Academy options below) 5th (Hei) Grade (Academy options below) 6th (Vav) Grade (Academy options below) 7th Grade (Zayin), $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am
* 4th (Dalet) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 5th (Hei) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 6th (Vav) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options
Student 4 Information
* What class is the student registering for? Please Select One Kindergarten (Gan) - $1,270, Sundays 9:30-11:45am 1st Grade (Alef) - $1,270, Sundays 9:30-11:45am 2nd Grade (Bet) - $1,780, Tuesdays 4:00-6:15pm and... 3rd Grade (Gimmel) - $1,780, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am 4th (Dalet) Grade (Academy options below) 5th (Hei) Grade (Academy options below) 6th (Vav) Grade (Academy options below) 7th Grade (Zayin), $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am
* 4th (Dalet) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 5th (Hei) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options * 6th (Vav) GradePlease Select One Beit Midrash Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Performing Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Technology Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Fine Arts Academy - $2,300, Tuesdays 4:00-6:15pm and Sundays 9:30-11:45am Learn more about the Academy options
Child/Children lives with Please Select One Both Parents Mother Father Guardian Other
* Number of Parents/Legal Guardians to addPlease Select One 1 2 3 4
Parents are: Please Select One Married Divorced Separated Widowed
Parent 1 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
Parent 2 Address Please Select One Same address as Parent 1 Enter new address
Parent 3 Address Please Select One Same address as Parent 1 Enter new address
Parent 4 Address Please Select One Same address as Parent 1 Enter new address
ENROLLMENT AND RESPONSIBILITY AGREEMENT
By typing below, I am acknowledging and agreeing to the following:
1. I/We understand that my/our child/children may not attend VBS Etz Chaim Learning Center unless I am a/we are member(s) in good standing of Valley Beth Shalom and that I/we have paid the full amount of the non-refundable tuition required for my/our child/children grade level(s). Should I/we need assistance with tuition it is my/our responsibility to contact the Valley Beth Shalom Administrative Office to set up the terms and conditions of my/our payment plan.
2. I/We understand that the Etz Chaim Learning Center will enforce a behavior management policy, and that all students are required to adhere to school and classroom policies as stipulated in the Etz Chaim Learning Center responsibility agreement in the parent/student guide. I/We understand that serious infractions such as, but not limited to, stealing, fighting, possession of contraband on campus (weapons, drugs or alcohol), willful destruction of school property, and/ or bullying (including sexual harassment) will result in an immediate removal from class and dismissal with no refund of tuition.
3. The Etz Chaim Learning Center makes no representations or guarantee as to any particular educational or social outcomes for my/our child/children. I understand that VBS may change its course offerings and activities, as well as its policies, procedures and practices, from time to time as circumstances may warrant, in its sole discretion.
4. Delinquency of payments due under this Enrollment Agreement may, at VBS' sole discretion, result in the suspension or dismissal of my/our child/children, from the Etz Chaim Learning Center.
5. I/We understand that the duties and obligations of the Etz Chaim Learning Center under this Agreement may be suspended immediately without notice during all periods that the it is closed or otherwise unable to perform its obligations under this Agreement because of force majeure events. A force majeure event shall mean any cause beyond the School’s control that prevents, delays, or otherwise interferes with the School’s performance of its obligations under this Agreement, and by way of example only, includes, but is not limited to fire, earthquake, flood, storm, accident, extreme weather events, acts of God, war, governmental action, terrorism, epidemic, pandemic, strike, or work stoppage. If such an event occurs, the School shall have no liability nor shall it be deemed to be in breach of this Agreement for any delay or failure to perform its duties and obligations in this Agreement, which may be suspended or postponed, at the sole discretion of the School. The School may also alter its calendar, provide alternate means of instruction, or take any other action it deems appropriate under the circumstances. In the event the School is unable to perform its obligations under this Agreement, or such performance is delayed or interfered with as a result of a force majeure, the School shall not be liable for any damage, remedy, or tuition refund. A closure or suspension of services due to a force majeure event shall not relieve me of any obligation, including, without limitation, payment obligations pursuant to this Agreement.
I/We have read, understood and agree to be bound by this enrollment agreement for myself/ourselves and on behalf of my/our child/children.
MEDICAL EMERGENCY RELEASE
In the event of a medical emergency, in accordance with the VBS Etz Chaim Learning Center’s emergency procedure, I/we, the undersigned parent(s)/legal guardians, do hereby release the appropriate personnel of Valley Beth Shalom to either administer first aid OR release the child/children to an emergency hospital or disaster center, for further treatment, as they deem necessary. Furthermore, I/we authorize appropriate personnel of Valley Beth Shalom acting on behalf of VBS Etz Chaim Learning Center, to consent to all emergency medical care for this child/children to be rendered by a duly licensed physician, surgeon, dentist and/or other medical professional. This care may be given under whatever conditions are necessary to preserve the health and safety of the child. I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, VBS Etz Chaim Learning Center personnel will try, but are not required, to communicate with me/us prior to.
PICK UP RELEASE
In accordance with the VBS Etz Chaim Learning Center’s emergency procedures, I authorize the release of my child/ children to the following (list below contacts that are located within close proximity to the school):
Number of people to allow to pick up Please Select One None One Person Two People Three People
PHOTO/AUDIO/WEBSITE RELEASE
I give permission for photographs, slides, video or audio to be taken of my child/children to be used for the VBS Etz Chaim Learning Center calendar, website, public relations and promotional purposes. I understand that none of the above may be used by the mass media for newspaper or television stories without my consent for usage.
DIRECTORY RELEASE
I give my permission for my name, address, telephone number, and email address to be given to other parents in the VBS Etz Chaim Learning Center.
FIELD TRIP R ELEASE
I give permission and consent to VBS Etz Chaim Learning Center and its employees and agents to take my child/children on field trips as part of the normal curriculum and, to the extent possible, absolve VBS Etz Chaim Learning Center and Valley Beth Shalom and its employees and agents from any liability for personal injury to my child or property damage, except for injuries resulting from gross negligence of VBS Etz Chaim Learning Center, Valley Beth Shalom or their employees or agents.
I understand that for all field trips that require transportation, I will receive a permission slip. Unless I have signed the permission slip my child will not be permitted to go on the trip.
MEMBERSHIP COMMITMENT
* Select your Membership Commitment - Single Membership (Select category based on age by 6/2021)Please Select One Synagogue Membership - 35 and under - $1,300 Synagogue Membership - 36-39 - $1,750 Synagogue Membership - 40+ - $1,980
* Select your Membership Commitment - Family Membership (Select age category of eldest adult by 6/2021)Please Select One Synagogue Membership - 35 and under - $2,185 Synagogue Membership - 36-39 - $2,900 Synagogue Membership - 40+ - $3,300
MANDATORY FEES
YOUR VBS COMMUNITY (Optional Items)
Enhance your Valley Beth Shalom membership to enjoy the best opportunities to share Jewish learning, caring for others and the celebration of life's greatest moments. Personalize your membership to best fit what matters most to you.
VBS Premier
Join the VBS Premier program to help us ensure that we never turn anyone away due to financial concerns. Your support is instrumental in helping to provide synagogue membership and Jewish education to everyone who deserves to be a part of the VBS family. Please Select One Premier PLUS+ $2,025 (includes additional benefits*) Premier $1,500 First-Time Premier $1,000 (join at a one-time only introductory rate) Premier Benefits include tickets to a Community Shabbat Dinner (arrangements TBD), complimentary membership for immediate family members to Sisterhood, Brotherhood and Youth Department
*Premier PLUS+ members will receive additional benefits:
-An intimate havdalah experience with VBS clergy
-LA|Kosher catered dinner for 4 delivered to your door
-Give the gift of membership including High Holiday Tickets or VBS TV! subscription (some restrictions apply )
Learn more at vbs.org/premier
Youth Department Membership
Grades K-12: Year-Round Social Programming Including USY - $100 per family Please Select One One child - $100 Two children - $100 Three children - $100 Four children - $100
Bachutz - Grades 6 -12: Outdoor adventures and education through a Judaic lens- $450 per child Please Select One One child - $450 Two children - $900 Three children - $1,350 Four children - $1,800 Youth programming to develop leadership skills, engage in social projects and create lasting friendships
Teen Tuesday (Post B’nai Mitzvah age programming) @ $500 per child Please Select One One child - $500 Two children - $1,000 Three children - $ 1,500 Four children - $2,000
Sisterhood Membership
A place for women of all ages and stages to connect and socialize
Brotherhood (Men's Club) Membership
Community-based activities for men
Mercaz
Mercaz works to increase the impact and influence of Conservative/Masorti Judaism on Israeli Society, encourages religious pluralism and secures funding for Masorti Movement programs.
Mercaz
Mercaz works to increase the impact and influence of Conservative/Masorti Judaism on Israeli Society, encourages religious pluralism and secures funding for Masorti Movement programs.
New Year's Greeting
Send High Holiday greetings to the VBS community
Scroll of Remembrance
Memorialize your loves ones in our Yizkor Book.
Scroll of Remembrance - $36 per name Please Select One One name - $36 Two names - $72 Three names - $108 Four names - $144 Five names - $180 Six names - $216
MEMBERSHIP CONTRIBUTION
* Payment OptionsPlease Select One Payment in Full Payment Plan ($50 fee applied)