Non-members are welcome to enroll children in preschool through grade 2 or in grades 9-12 for two years. There is an additional fee for doing so. If your children are in grades 3-8, please contact our Director of Learning, Abra Greenspan (abra@etzchayim.org) before completing this form.

Child 1

Preferred Name *

Last Name *

Hebrew Name * 🛈

Preferred pronouns *

Birthdate * +

Name of Regular School * 🛈

Grade at Etz (Fall 2024) *

Grade in Regular School (Fall 2024) *

Student Email Address

Student cell

To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.

Child 2

Preferred Name *

Last Name *

Hebrew Name * 🛈

Preferred pronouns *

Birthdate * +

Name of Regular School * 🛈

Grade at Etz (Fall 2024) *

Grade in Regular School (Fall 2024) *

Student Email Address

Student cell

To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.

Child 3

Preferred Name *

Last Name *

Hebrew Name * 🛈

Preferred pronouns *

Birthdate * +

Name of Regular School * 🛈

Grade at Etz (Fall 2024) *

Grade in Regular School (Fall 2024) *

Student Email Address

Student cell

To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.

Child 4

Preferred Name *

Last Name *

Hebrew Name * 🛈

Preferred pronouns *

Birthdate * +

Name of Regular School * 🛈

Grade at Etz (Fall 2024) *

Grade in Regular School (Fall 2024) *

Student Email Address

Student cell

To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.