{"id":30317,"date":"2022-07-18T16:05:49","date_gmt":"2022-07-18T20:05:49","guid":{"rendered":"https:\/\/jewishpb.org\/fed\/?page_id=30317"},"modified":"2024-07-16T14:20:47","modified_gmt":"2024-07-16T18:20:47","slug":"yad-hebrew-school-registration-form","status":"publish","type":"page","link":"https:\/\/jewishpb.org\/fed\/yad-hebrew-school-registration-form\/","title":{"rendered":"Yad Hebrew School Registration Form"},"content":{"rendered":"<h2 style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-30215\" src=\"https:\/\/jewishpb.org\/fed\/wp-content\/uploads\/2022\/07\/Yad-Registration-Header_1200x630.jpg\" alt=\"\" width=\"536\" height=\"281\" srcset=\"https:\/\/jewishpb.org\/fed\/wp-content\/uploads\/2022\/07\/Yad-Registration-Header_1200x630.jpg 1200w, https:\/\/jewishpb.org\/fed\/wp-content\/uploads\/2022\/07\/Yad-Registration-Header_1200x630-768x403.jpg 768w\" sizes=\"auto, (max-width: 536px) 100vw, 536px\" \/><\/h2>\n<h3 style=\"text-align: center;\">The J.N. Somers Yad Hebrew School for Children with Differing Abilities<br \/>\nat Temple Beth Torah, Wellington<br \/>\n<strong>Sundays 9 a.m. to 12 p.m., beginning in August<br \/>\n<\/strong><\/h3>\n<h2 style=\"text-align: center;\">REGISTRATION FORM<br \/>\n2024-2025 School Year<\/h2>\n<p>&nbsp;<\/p>\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-30299\"><form id=\"wpforms-form-30299\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"30299\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/fed\/wp-json\/wp\/v2\/pages\/30317\" data-token=\"76653bd639f3e094aaeb8218418f899f\" data-token-time=\"1780734266\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-30299-field_16-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"16\"><h3 id=\"wpforms-30299-field_16\">STUDENT INFORMATION<\/h3><\/div><div id=\"wpforms-30299-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"1\"><label class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-two-fifths\"><input type=\"text\" id=\"wpforms-30299-field_1\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][1][first]\" required><label for=\"wpforms-30299-field_1\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-fifth\"><input type=\"text\" id=\"wpforms-30299-field_1-middle\" class=\"wpforms-field-name-middle\" name=\"wpforms[fields][1][middle]\" ><label for=\"wpforms-30299-field_1-middle\" class=\"wpforms-field-sublabel after\">Middle<\/label><\/div><div class=\"wpforms-field-row-block wpforms-two-fifths\"><input type=\"text\" id=\"wpforms-30299-field_1-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][1][last]\" required><label for=\"wpforms-30299-field_1-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-30299-field_3-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_3\">Hebrew Name (optional)<\/label><input type=\"text\" id=\"wpforms-30299-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" ><\/div><div id=\"wpforms-30299-field_47-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-type=\"date-time\" data-field-id=\"47\"><label class=\"wpforms-field-label\">Birthdate <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-medium\"><select name=\"wpforms[fields][47][date][m]\" id=\"wpforms-30299-field_47-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><select name=\"wpforms[fields][47][date][d]\" id=\"wpforms-30299-field_47-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>DD<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><select name=\"wpforms[fields][47][date][y]\" id=\"wpforms-30299-field_47-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><\/select><\/div><\/div><div id=\"wpforms-30299-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_8\">Grade  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-30299-field_8\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][8]\" required><\/div><div id=\"wpforms-30299-field_9-container\" class=\"wpforms-field wpforms-field-radio\" data-field-type=\"radio\" data-field-id=\"9\"><label class=\"wpforms-field-label\">Gender <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-30299-field_9\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_9_1\" name=\"wpforms[fields][9]\" value=\"Male\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_9_1\">Male<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_9_2\" name=\"wpforms[fields][9]\" value=\"Female\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_9_2\">Female<\/label><\/li><\/ul><\/div><div id=\"wpforms-30299-field_11-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-type=\"textarea\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_11\">Siblings and Ages  <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-30299-field_11\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][11]\" required><\/textarea><\/div><div id=\"wpforms-30299-field_12-container\" class=\"wpforms-field wpforms-field-address\" data-field-type=\"address\" data-field-id=\"12\"><label class=\"wpforms-field-label\">Address  <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-30299-field_12\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][12][address1]\" required><label for=\"wpforms-30299-field_12\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-30299-field_12-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][12][address2]\" ><label for=\"wpforms-30299-field_12-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-30299-field_12-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][12][city]\" required><label for=\"wpforms-30299-field_12-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-30299-field_12-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][12][state]\" required><option class=\"placeholder\" value=\"\" selected disabled>--- Select state ---<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-30299-field_12-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-30299-field_12-postal\" class=\"wpforms-field-address-postal wpforms-field-required wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][12][postal]\" required><label for=\"wpforms-30299-field_12-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-30299-field_13-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-type=\"textarea\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_13\">Please describe disabilities, including health issues and allergies <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-30299-field_13\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][13]\" required><\/textarea><\/div><div id=\"wpforms-30299-field_17-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"17\"><h3 id=\"wpforms-30299-field_17\">EDUCATION AND AFFILIATION<\/h3><\/div><div id=\"wpforms-30299-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_18\">Name of Student\u2019s School  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-30299-field_18\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][18]\" required><\/div><div id=\"wpforms-30299-field_21-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-type=\"checkbox\" data-field-id=\"21\"><label class=\"wpforms-field-label\">Exceptional Student Education Program  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-30299-field_21\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-30299-field_21_1\" name=\"wpforms[fields][21][]\" value=\"LD\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_21_1\">LD<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-30299-field_21_2\" name=\"wpforms[fields][21][]\" value=\"EH\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_21_2\">EH<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-30299-field_21_3\" name=\"wpforms[fields][21][]\" value=\"Other\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_21_3\">Other<\/label><\/li><\/ul><\/div><div id=\"wpforms-30299-field_45-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"text\" data-field-id=\"45\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_45\">Please explain  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-30299-field_45\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][45]\" required><\/div><div id=\"wpforms-30299-field_22-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_22\">Name of Synagogue <\/label><input type=\"text\" id=\"wpforms-30299-field_22\" class=\"wpforms-field-medium\" name=\"wpforms[fields][22]\" ><\/div><div id=\"wpforms-30299-field_23-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_23\">Religious Affiliation  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-30299-field_23\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][23]\" required><\/div><div id=\"wpforms-30299-field_24-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"24\"><h3 id=\"wpforms-30299-field_24\">FAMILY INFORMATION<\/h3><\/div><div id=\"wpforms-30299-field_48-container\" class=\"wpforms-field wpforms-field-radio wpforms-conditional-trigger\" data-field-type=\"radio\" data-field-id=\"48\"><label class=\"wpforms-field-label\">Student lives with (select one) <\/label><ul id=\"wpforms-30299-field_48\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_48_1\" name=\"wpforms[fields][48]\" value=\"Mother and Father\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_48_1\">Mother and Father<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_48_2\" name=\"wpforms[fields][48]\" value=\"Mother\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_48_2\">Mother<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_48_3\" name=\"wpforms[fields][48]\" value=\"Father\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_48_3\">Father<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_48_4\" name=\"wpforms[fields][48]\" value=\"Other\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_48_4\">Other<\/label><\/li><\/ul><\/div><div id=\"wpforms-30299-field_26-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"text\" data-field-id=\"26\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_26\">Please Indicate Relationship  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-30299-field_26\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][26]\" required><\/div><div id=\"wpforms-30299-field_27-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"27\"><label class=\"wpforms-field-label\">Parent 1\/Guardian 1 Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-30299-field_27\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][27][first]\" required><label for=\"wpforms-30299-field_27\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-30299-field_27-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][27][last]\" required><label for=\"wpforms-30299-field_27-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-30299-field_28-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_28\">Parent 1\/Guardian 1 Cell Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-30299-field_28\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][28]\" aria-label=\"Parent 1\/Guardian 1 Cell Phone\" required><\/div><div id=\"wpforms-30299-field_35-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"35\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_35\">Parent 1\/Guardian 1 Home Phone:<\/label><input type=\"tel\" id=\"wpforms-30299-field_35\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][35]\" aria-label=\"Parent 1\/Guardian 1 Home Phone:\" ><\/div><div id=\"wpforms-30299-field_36-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"36\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_36\">Parent 1\/Guardian 1 Work Phone<\/label><input type=\"tel\" id=\"wpforms-30299-field_36\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][36]\" aria-label=\"Parent 1\/Guardian 1 Work Phone\" ><\/div><div id=\"wpforms-30299-field_29-container\" class=\"wpforms-field wpforms-field-email\" data-field-type=\"email\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_29\">Parent 1\/Guardian 1 Email  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-30299-field_29\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][29]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-30299-field_30-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"30\"><label class=\"wpforms-field-label\">Parent 2\/Guardian 2 Name (optional) <\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-30299-field_30\" class=\"wpforms-field-name-first\" name=\"wpforms[fields][30][first]\" ><label for=\"wpforms-30299-field_30\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-30299-field_30-last\" class=\"wpforms-field-name-last\" name=\"wpforms[fields][30][last]\" ><label for=\"wpforms-30299-field_30-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-30299-field_32-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_32\">Parent 2\/Guardian 2 Cell Phone<\/label><input type=\"tel\" id=\"wpforms-30299-field_32\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][32]\" aria-label=\"Parent 2\/Guardian 2 Cell Phone\" ><\/div><div id=\"wpforms-30299-field_37-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"37\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_37\">Parent 2\/Guardian 2 Home Phone <\/label><input type=\"tel\" id=\"wpforms-30299-field_37\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][37]\" aria-label=\"Parent 2\/Guardian 2 Home Phone \" ><\/div><div id=\"wpforms-30299-field_38-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_38\">Parent 2\/Guardian 2 Work Phone <\/label><input type=\"tel\" id=\"wpforms-30299-field_38\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][38]\" aria-label=\"Parent 2\/Guardian 2 Work Phone \" ><\/div><div id=\"wpforms-30299-field_33-container\" class=\"wpforms-field wpforms-field-email\" data-field-type=\"email\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_33\">Parent 2\/Guardian 2 Email<\/label><input type=\"email\" id=\"wpforms-30299-field_33\" class=\"wpforms-field-medium\" name=\"wpforms[fields][33]\" spellcheck=\"false\" ><\/div><div id=\"wpforms-30299-field_34-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-type=\"textarea\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_34\">Emergency Contact (please include name, number and relationship)  <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-30299-field_34\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][34]\" required><\/textarea><\/div><div id=\"wpforms-30299-field_39-container\" class=\"wpforms-field wpforms-field-divider\" data-field-type=\"divider\" data-field-id=\"39\"><h3 id=\"wpforms-30299-field_39\">Photo Release<\/h3><\/div><div id=\"wpforms-30299-field_40-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"40\"><label class=\"wpforms-field-label\">I\/we am\/are aware that cameras are on and continuously recording for internal monitoring and viewing purposes only. <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-30299-field_40\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-30299-field_40_1\" name=\"wpforms[fields][40][]\" value=\"Yes\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_40_1\">Yes<\/label><\/li><\/ul><\/div><div id=\"wpforms-30299-field_41-container\" class=\"wpforms-field wpforms-field-radio\" data-field-type=\"radio\" data-field-id=\"41\"><label class=\"wpforms-field-label\">I GIVE PERMISSION for my child\u2019s photograph to be taken and used to represent The J.N. Somers Yad Hebrew School via various Jewish Federation of Palm Beach County\/Commission for Jewish Education outlets.  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-30299-field_41\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_41_1\" name=\"wpforms[fields][41]\" value=\"Yes\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_41_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-30299-field_41_2\" name=\"wpforms[fields][41]\" value=\"No\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-30299-field_41_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-30299-field_42-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"42\"><label class=\"wpforms-field-label\" for=\"wpforms-30299-field_42\">Entering the parent\/guardian\u2019s name below constitutes an online signature. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-30299-field_42\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][42]\" required><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"30299\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/pages\/30317\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-30299\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/jewishpb.org\/fed\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n<p>&nbsp;<\/p>\n<h4><strong>For financial assistance or if you have any questions, please contact Alyssa Danick 561.209.2614 <a title=\"mailto:alyssa.danick@jewishpalmbeach.org\" href=\"mailto:alyssa.danick@jewishpalmbeach.org\" data-outlook-id=\"61548370-405a-444c-ba26-ae650bffbdad\">alyssa.danick@jewishpalmbeach.org<\/a>. <\/strong>All personal information is held in the strictest confidence.<\/h4>\n","protected":false},"excerpt":{"rendered":"<p>The J.N. Somers Yad Hebrew School for Children with Differing Abilities at Temple Beth Torah, Wellington Sundays 9 a.m. to 12 p.m., beginning in August REGISTRATION FORM 2024-2025 School Year<br \/><a class=\"moretag\" href=\"https:\/\/jewishpb.org\/fed\/yad-hebrew-school-registration-form\/\">+ Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-30317","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/pages\/30317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/comments?post=30317"}],"version-history":[{"count":11,"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/pages\/30317\/revisions"}],"predecessor-version":[{"id":57418,"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/pages\/30317\/revisions\/57418"}],"wp:attachment":[{"href":"https:\/\/jewishpb.org\/fed\/wp-json\/wp\/v2\/media?parent=30317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}