Are you a new or returning member?

Confirm Household Information

Adult #1

* First Name

* Last Name

* Email

* Mobile

* Occupation

Pronouns

Are you interested in volunteering?

YesNo

If yes, in which area:

I would like to receive Shoresh group texts or WhatsApp with social or important information

YesNo

**Adult #2 (if applicable)**

First Name

Last Name

Mobile

Occupation

Pronouns

Are you interested in volunteering?

YesNo

If yes, in which area:

I would like to receive Shoresh group texts or WhatsApp with social or important information

YesNo

Household Contact Information

* Home or Primary Phone

* Primary Address

Apt/Unit/PO Box

* City

* State

* Zip Code

Please fill out the fields below for the learner(s) you are enrolling.

Click here for more information about our program offerings.

Learner Information #1

* Learner Grade This Fall -

* First Name

* Last Name

Birthday

Learner's Phone Number

Learner Email

Year of High School Graduation

Pronouns

Learner's Address is Same as Household Information

YesNo (fill out separate following box)

If Learner's Address is Different, Please Enter Below:

* Enter Learner's School Information

Does your learner have any learning differences or special needs?

My learner has an IEP/ 504 plan at school

YesNo

Does your learner have any allergies?

If your learner requires medication during Shoresh please specify.

Check here if you would like individual follow-up

My learner is 13 years of age or older and I give permission for them to receive information about KAMII teen and young adult programming

I give my learner permission to check themselves out of Shoresh and walk themselves out of the building.

I understand and agree that my learner's photo may appear on our shabbat slides, promotional KAMII materials or social media.

Comments on Social Media Photo Use

* My learner is in 2nd-6th grade and we would like to enroll in Hebrew@Home

Hebrew@Home is our weekly, virtual 1-1, Hebrew learning program. An important part of Shoresh, learners are expected to have a certain level of Hebrew proficiency before b'nai mitzvah. Those opting out of Hebrew@home should be receiving Hebrew and liturgical learning elsewhere.

Has your learner studied Hebrew before?

Please share your learner's Hebrew speaking level

Please share your learner's Hebrew prayer reading level

Do you have additional learners to enroll?

Click here for more information about our program offerings.

Learner Information #2

* Learner Grade This Fall -

* First Name

* Last Name

Birthday

Learner's Phone Number

Learner Email

Year of High School Graduation

Pronouns

Learner's Address is Same as Household Information

YesNo (fill out separate following box)

If Learner's Address is Different, Please Enter Below:

* Enter Learner's School Information

Does your learner have any learning differences or special needs?

My learner has an IEP/ 504 plan at school

YesNo

Does your learner have any allergies?

If your learner requires medication during Shoresh please specify.

Check here if you would like individual follow-up

My learner is 13 years of age or older and I give permission for them to receive information about KAMII teen and young adult programming

I give my learner permission to check themselves out of Shoresh and walk themselves out of the building.

I understand and agree that my learner's photo may appear on our shabbat slides, promotional KAMII materials or social media.

Comments on Social Media Photo Use

* My learner is in 2nd-6th grade and we would like to enroll in Hebrew@Home for an additional cost.

Has your learner studied Hebrew before?

Please share your learner's Hebrew speaking level

Please share your learner's Hebrew reading level

Do you have additional learners to enroll?

Click here for more information about our program offerings.

Learner Information #3

* Learner Grade This Fall -

* First Name

* Last Name

Birthday

Learner's Phone Number

Learner Email

Year of High School Graduation

Pronouns

Learner's Address is Same as Household Information

YesNo (fill out separate following box)

If Learner's Address is Different, Please Enter Below:

* Enter Learner's School Information

Does your learner have any learning differences or special needs?

My learner has an IEP/ 504 plan at school

YesNo

Does your learner have any allergies?

If your learner requires medication during Shoresh please specify.

Check here if you would like individual follow-up

My learner is 13 years of age or older and I give permission for them to receive information about KAMII teen and young adult programming

I give my learner permission to check themselves out of Shoresh and walk themselves out of the building.

I understand and agree that my learner's photo may appear on our shabbat slides, promotional KAMII materials or social media.

Comments on Social Media Photo Use

* My learner is in 2nd-6th grade and we would like to enroll in Hebrew@Home for an additional cost.

Has your learner studied Hebrew before?

Please share your learner's Hebrew speaking level

Please share your learner's Hebrew reading level

I am interested in signing up my child (3rd grade +) for SKIP (Send a Kid to Israel Partnership), a special savings plan that helps Chicago area Jewish youth visit Israel.

YesNoAlready Enrolled

My child is in 4th grade or above and we need to pick a b'nai mitzvah date.

If yes, then: Please cross check our KAMII calendar and Jewish holidays and propose three possible dates.

- Dates are subject to availability
- Payment will be requested when date is confirmed
- Requirements for b'nai mitzvah: KAMII membership, being a part of the community for a year before date.

Emergency Contact Information

Who would you like to contact in case of an emergency?

Household Member 1Household Member 2Other

* Other Emergency Contact: Non-parent name, Cell phone, Relationship to child(ren)

In case of injury or illness, every effort will be made to contact the parent(s)/guardian(s). Please provide an additional contact in the event that the parent(s)/guardian(s) cannot be reached

* I authorize emergency treatment if necessary and indemnify the School and KAM Isaiah Israel from any liabilities.

I authorize emergency treatment if necessary and indemnify the School and KAM Isaiah Israel from any liabilities.

Shoresh Tuition Commitment

Tuition is essential for maintaining the high standards of our school, enabling us to provide top-quality Jewish education. Through tuition fees, we are also able to offer scholarships and financial aid, making it possible for every student to access the opportunities our school provides. The following elements are what it takes to maintain Shoesh as a service to our community: Teachers, recruitment, email platform, supplies, space, maintenance staff, food, AV, program management and more.

If you have any questions about which commitment level is right for you or how to make an adjustment from last year, please reach out to Osnat Strulov-Shlain, Executive Director at osnat@kamii.org

For general questions and/or assistance with this form submission, please reach out to Cody Gierat, Membership & Operations Manager at cgierat@kamii.org

More information can be found here: https://www.kamii.org/shoresh

I need financial assistance to meet tuition

YesNo

If seeking financial assistance, please reach out to Osnat - osnat@kamii.org / 773-840-2641

Form Submission & Payment Information

The "Total Amount Due" in the field below is your total Shoresh Tuition, based on your form entry.

After completing this form and scrolling down to click "Confirm Payment Information" you will be prompted to make payment arrangements for your total 2024-2025 pledge and Shoresh tuition (if applicable). Payment options are as follows:

Pay in full today by credit card (2.5% fee) or by eCheck (no fee)
Pay in full by check, mailed to KAMII (no fee)
Pay in multiple payments between now and June 30, 2025 using a credit card (2.5% fee) or eCheck (no fee)
Pay via Zelle -- use 'info@kamii.org' as the contact information submission.
Bill your account and contact the office for assistance making payment arrangements between now and June 30, 2025

By clicking here - your contributions to Shoresh enable the continuation of this program. Sponsor Amount is: $180.00

If you can give more, please consider an additional amount to sponsor additional families who are unable to pay at this time.

2024-25 Shoresh Enrollment🍎

Are you a new or returning member?

Confirm Household Information

Adult #1

**Adult #2 (if applicable)**

Household Contact Information

Please fill out the fields below for the learner(s) you are enrolling.

Click here for more information about our program offerings.

Learner Information #1

Click here for more information about our program offerings.

Learner Information #2

Click here for more information about our program offerings.

Learner Information #3

Emergency Contact Information

Shoresh Tuition Commitment

I need financial assistance to meet tuition

If seeking financial assistance, please reach out to Osnat - osnat@kamii.org / 773-840-2641

Form Submission & Payment Information

TOTAL AMOUNT DUE