Welcome to the 2020-2021 Beth Shalom Youth Department. We have a fun and exciting year planned! Please fill out the information below for every child in your family from kindergarten to 12th grade. To ensure safety and accurate communication, youth cannot attend events without completing this form.  Thank you in advance for your cooperation! Please note: THIS IS NOT A BILL


The cost for each of the groups is:
BSUSY (8th-12th grade) - $80.00 
Kadima (5th-7th grade) - $65.00
Atid (2nd-4th grade) - $36.00
Chaverim (K-1st grade) - $18.00

The youth group cost will be added to your Congregation Beth Shalom dues. 

Thank you,

Marissa Tait, Director of Youth Programming
Judith Kadosh, Youth Commission Chair
Adi Kadosh, BSUSY Advisor
Harris Jayson, Kadima Advisor

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Family Information

* Indicates Response Required

Child Information

Child 1

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Preferred Pronouns *
 

Child 2

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Preferred Pronouns
 

Child 3

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Preferred Pronouns
 

Child 4

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Preferred Pronouns
 

Parent/Guardian Information

Parent/Guardian 1 (where student resides)

Parent/Guardian 2


Please List Two "In-Case of Emergency" individuals. *These individuals may be contacted if unable to reach a parent/guardian*