2022-23 CHALLAH Teen Registration, Winter (Financial Aid) - Form

Join us for CHALLAH, Winter 2022-2023!

The winter trimester of CHALLAH begins on January 5th, and we would love to see you there! Please see below for more information and to enroll.

CHALLAH is a new, weekly series of classes for teens in grades 8th-12th. CHALLAH is hosted by CBI and open to all! CHALLAH classes are designed to:

deepen Jewish knowledge through focused skill-building
prepare teens to enter the world as well-rounded Jewish young adults
help develop lifelong Jewish learners
foster Jewish joy!

CHALLAH meets on Thursday nights with the exception of school breaks and Jewish holidays, from 6:00pm-8pm. Each session includes a one-hour class, a community gathering led by Rabbi Ariella, social time, and an optional dinner.

CHALLAH Dates:

חורף / choref / winter trimester: January 5th - March 2nd

אֲבִיבֵ / aviv / spring trimester: March 16th - May 25th

Requesting Financial Aid

Please note: This is the form for families requesting financial aid. If you are NOT requesting financial aid, please fill out this form instead:

https://www.cbinorthampton.org/form/2022-23-challah-teen-registration-T2.html

Section A: Family or Caregiver Contact Information

* First Name (Primary)

* Last Name (Primary)

* Email (Primary)

* Phone (Primary)

* Relationship to Student(s) (Primary)

* Street Address (Primary)

Street Address Line 2 (Primary)

* City (Primary)

* State (Primary)

* ZIP (Primary)

* Is there a secondary contact?

Please Select OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf there is a secondary contact, all emails and mailings will go to both contacts. In case of urgent need, the primary contact will be notified first

* First Name (Secondary)

* Last Name (Secondary)

* Email (Secondary)

* Phone (Secondary)

* Relationship to Student(s) (Secondary)

* Street Address (Secondary)

Street Address Line 2 (Secondary)

* City (Secondary)

* State (Secondary)

* ZIP (Secondary)

* Emergency Contact Name

* Emergency Contact Best Phone

* Emergency Contact Relationship

Family Physician Name

Family Physician Phone Number

Insurance Group or ID#

Medical Insurance Provider

Section B: Student Enrollment Information

CHALLAH Tuition makes it possible for our program to sustain educators, specialists, and provide materials for students. Tuition does NOT cover all of our staffing and overhead needs and is significantly subsidized by CBI. CHALLAH tuition fees can be paid one time annually or monthly through a payment plan. Financial aid is available to CBI members. Monthly payments will begin with a first payment when you submit this form. The next payment will be on January 15th and on the 15th of the month until June (6 months total).

CHALLAH Tuition Rates

Individual trimester ($320), monthly payment $32 for 10 months

Dinner, 6pm-6:45pm
For those who wish to opt-in, we will be providing vegetarian dinner from local restaurants or prepped at CBI from 6pm-6:45pm each week prior to the start of each CHALLAH session. This is open to all CHALLAH students at an additional cost of $80 per trimester.

* How many teens are being enrolled in CHALLAH?

Please Select One1 Teen2 TeensPlease fill out an additional form for any additional teens over 2.

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

What pronouns do you use?

Student 1's Grade as of Fall 2022

* Student 1 Preferred Name

Student 1 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 1 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 1 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 1 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

* What helps you to best enjoy learning? Please tell us below:

* Student 1: Do you have a formal IEP or 504 plan?

Please Select OnePlease select oneYesNoIf yes, we will be in touch before the start of the trimester to best understand how to support you.

Optional Dinner 6:00pm: We are offering dinner at a cost of $80 per trimester for any teens who would like to arrive early, and eat and socialize with your peers.

Student 1: Choose Your Course!

Winter Trimester Course Descriptions

Garage Band, Literally
Come and rock out with Aram in the garage of the new building! We will explore different kinds of Jewish music, and question what makes music Jewish. We'll learn music from Shabbat services that will help you lead songs not only in our own community, but also at camp, college, or even just a campfire with your friends. You do not need to be an accomplished musician to join the band! If your thing is singing, we’d love to have your voice! If you dance, then come and show off your moves. If you’re into banging on a drum, come add some rhythm. By the end of the trimester, our Jewish Rock Orchestra will help to lead a service at CBI. We look forward to making music together!

Crafting Judaica
Join Abundance Farm's Miriam Kudler-Flam to look at the role of craft-making in Jewish rituals and traditions. We will ask these questions to inspire our art-making: How can we bring to life “hiddur mitzvah” (the principle of beautifying ritual objects like kiddish cups and mezuzot) in modern and personally relevant ways? Where do common symbols and imagery in Jewish art and objects come from? How have societies through time influenced the ways that Jews make art around the world? The projects that we create will be both ritually useful and aesthetically beautiful (think candle making, paper cutting, and more)! This is a great course for artists of ALL experience levels.

Supper Club (11th and 12th grade only- enrollment permitting, 10th graders might be considered)
When the rest of CHALLAH leaves for their other classes, linger over dinner for relaxed and meaningful group discussions facilitated by Rabbi Ariella. Topics might range from current events to big questions exploring identity, community, and how we prepare for life after high school. We'll set the agenda together.

CHALLAH courses to look forward to in future trimesters: Hebrew, Meditation, Graphic Novels, Forest Exploration, Food Studies. Please note that course selection for spring will become available later in the year.

My first choice is:

My second choice is:

Student 2 Information

* Student 2 First Name

* Student 2 Last Name

* Student 2 Birthdate

What pronouns do you use?

Student 2's Grade as of Fall 2022

* Student 2 Preferred Name

Student 2 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 2 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 2 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 2 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

* What helps you to best enjoy learning? Please tell us below:

Do you have a formal IEP or 504 plan?

Please select oneYesNoIf yes, we will be in touch before the start of the trimester to best understand how to support you.

Optional Dinner 6:00pm: We are offering dinner at a cost of $80 per trimester for any teens who would like to arrive early, and eat and socialize with your peers.

Student 2: Choose Your Course!

My first choice is:

My second choice is:

Section C: Release Forms

* For Parents/Caregivers: CHALLAH WAIVER OF LIABILITY (22/23) With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and hold harmless Congregation B’nai Israel, its board members, officers, agents, servants, independent contractors, affiliates, employees, successors, and assigns (collectively the "Released Parties") from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or any member of my family related to COVID-19 or any other infectious diseases, whether caused by the negligence of the Released Parties or otherwise, while attending CHALLAH, participating in any activities on Congregation B’nai Israel premises or using any of its facilities or equipment. By signing below I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed. I am sufficiently informed about the risks involved in attending CHALLAH and making use of its facilities and equipment to decide whether to sign this document. No oral representations, statements, or inducements, apart from the foregoing written agreement, have been made to me. I am at least eighteen (18) years of age and fully competent. I execute this document for full, adequate, and complete consideration fully intending to be bound by the same. I agree that this Waiver of Liability shall be governed by and construed in accordance with the law of the Commonwealth of Massachusetts, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit its enforcement as a whole.

By typing my name, I have read and understand the above statement.

* For Parents/Caregivers: Memorandum of Understanding: CHALLAH Staff will review appropriate behaviors and expectations with students. Bullying, including cyberbullying, during a session or outside of a session will not be tolerated. Issues and consequences will be addressed with the student and a parent.

By typing my name, I have read and understand the above statement.

* Media Release for Parents/Caregivers: From time to time your teen's photo may be taken in our classrooms or at special events. We use these photos in our newsletters, on our website, in our Facebook posts and other publicity materials.

Please Select OneI grant permission for my child(ren)'s image to be used in all mediaI grant permission for my child(ren)'s image to be used only in internal synagogue mediaI do not grant permission for my child(ren)’s image to be used

Section D: Additional Information

Is there anything else you want us to know about you or your family as we enter into the school year?