Gan Katan 2022-2023 Enrollment - Form - Sutton Place Synagogue

Thank you for your interest in Gan Katan 2022 for your PreK child! We are excited to learn and grow together. Our forty-five minute in-person sessions are centered around Jewish connection, music, stories, craft projects and activities, and friendship.

Our 2022-2023 program will occur on Tuesdays from 3:30-4:15 pm. The dates for Winter/Spring are:

Winter/Spring Session: 1/10, 1/17, 1/24, 1/31, 2/7, 2/14. 2/28, 3/7, 3/14, 3/21, 3/28, 4/18, 4/25, 5/2, 5/9 and 5/16

SPS Member Price Per Session: $500

Community Member Price Per Session: $600

* Child's Name:

* Child's Gender:

* Child's DOB:

* Child's Age:

* Child's Daytime School for 2022-2023:

* Child's Grade in Daytime School in 2022-2023:

* Does Sutton Place Synagogue have permission to use pictures and/or video of your child on our website/social media or in official digital or printed publications as long as your child is not identified by name?

Please Select OneYesNo

* Does your child have any allergies or other needs that might limit the activities in which they can participate? If yes, please describe them.

* Does your child have an IEP at school or any accommodations that might help us to make Gan Katan more meaningful? If yes, please describe them.

* Please list any prescription medications and health concerns that your child may have:

* Child's Doctor: Name, Phone # & Address

* If the need for medical and/or surgical attention arises during the period of my child's official participation in Gan Katan at Sutton Place Synagogue, I hereby grant permission for my child to be transported by private vehicle or ambulance to an appropriate medical facility and to be treated by qualified medical authorities at their discretion and that of the program leaders.

If the need for medical and/or surgical attention arises during the period of my child's official participation in Gan Katan at Sutton Place Synagogue, I hereby grant permission for my child to be transported by private vehicle or ambulance to an appropriate medical facility and to be treated by qualified medical authorities at their discretion and that of the program leaders.

* Sutton Place Synagogue is thrilled to partner with PJ Library to offer your family the gift of free Jewish books! PJ Library sends free books that celebrate Jewish values and culture to families with children from birth through age 12. Your family will receive a free Jewish themed book in the mail every month that is age-appropriate for your child. We are excited to offer you this gift and hope your family enjoys reading the books together. Please select one of the following:

Please Select OneWe already receive PJ Library books and don't need to be signed up.Yes, please sign us up for free monthly books from PJ Library.No thanks, we aren't interested at this time.

* Parent/Guardian 1 Name:

* Parent/Guardian 1 Email:

* Parent/Guardian 1's Phone Number:

Parent/Guardian 2 Name:

Parent/Guardian 2 Email:

Parent/Guardian 2's Phone Number:

* Will a caregiver be picking up from Gan Katan at 4:15 pm?

Please Select Oneyesno

* Caregiver's Name & Phone Number:

* Emergency Contact--Name, Phone Number & Relationship to Child:

Please select which session(s) you'd like to enroll in:

Winter/Spring Session - Member of SPS ($500)Winter/Spring Session - Nonmember of SPS ($600) If you are interested in becoming a member and receiving the member rate, please email Abby at ajohnson@spsnyc.org

General Waiver:
I understand that this program will only be offered if the minimum number of participants is reached. By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature in reference to the Photo/Video release, medical release, and general waiver. The electronic signature will be equally as binding as an original manual paper signature.

* Electronic Signature:

* Date: