Registration Form

Now Accepting Applications for the 2023-2024 School Year!
Program of Interest
What Date Would You Like Your Child to Begin*

Month Day Year
Please Check the Program of Interest*

10 Month Program (part time) 12 Month Program (full time)
Please Check the Days of Interest*

Monday Tuesday Wednesday Thursday Friday
Please Check the Hours of Interest*

9 AM - 12 PM 9 AM - 3 PM 8 AM - 6 PM
3K/UPK hours ONLY

8:40 AM - 3:30 PM
Child Information
Child's Full Name*

First Name Last Name
Hebrew Name
Date of Birth*

Month Day Year
Gender*

Male Female
Phone Number*
Child Resides With*

Home Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Child's Age Next September (Month/Year)*
Previous/Current School or Playgroup
May we have permission to contact them?

Yes No
Previous/Current School or Playgroup Phone Number
Parent/Guardian Information
Parent 1
Full Name*

First Name Last Name
Jewish?*

Yes No
If Jewish, Hebrew Name

Home Address (if different from child's)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Cellphone Number
E-mail Address*
Occupation*

Work Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent 2
Full Name*

First Name Last Name
Jewish?*

Yes No
If Jewish, Hebrew Name

Home Address (if different from child's)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Cellphone Number
E-mail Address*
Occupation*

Work Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parental Involvement
It is our belief that a child’s learning experience is enhanced when his/her parents are actively involved in sharing the experience. Furthermore, parental involvement in the preschool’s organization and activities helps the preschool to function at its highest level. We therefore, encourage all of our parents to find ways of participating in their child’s Jewish education and offer the following opportunities for your consideration.
Would You Be Interested In
Becoming a Class Parent

Yes No
Assisting a Class Parent

Yes No
Helping with Special Holiday Celebrations

Yes No
Reading or Telling a Story

Yes No
Would you like to volunteer for Stoop Soup - A project to deliver fresh soup and Challah or holiday meals to our local seniors by Kiddie Korner Preschool parents and children as well as local community members and spreading a little laughter and joy.
Sharing an Experience or Professional Knowledge with a Class (e.g., a baby naming, a personal tzedakah project, a trip to Israel, work-related experiences, ethical dilemmas, a Judaica collection, etc.)

Yes No
Receive Rabbi Raskin's Weekly Newsletter and Videos

Yes No
If yes, please indicate which parent(s)
Would you be Interested in Taking an Adult Study Course in:
Basic Judaism

Yes No
Hebrew

Yes No
Torah and Text Study

Yes No
Kabbalah & Mysticism

Yes No
Other (please specify)
Disclaimer
If for any reason you must pull out of our program without giving Kiddie Korner a 2-month notice you will lose your $1000 non-refundable deposit fee and the additional 2-months of tuition. Should you give Kiddie Korner proper prior notice you will receive the 2-months tuition only.*

I understand
I am aware that if my child’s enrollment will start after the 1st of the month, I will still be responsible for paying the full month of tuition.*

I understand
In case of extended closures due to a pandemic or a public health emergency that arise in school during regular sessions or summer camp, Kiddie Korner Preschool will not refund any tuition or deposit fees that were paid prior to the schools closure. In addition, any new registrations will not be refunded as well even if the child did not start care.*

I understand
Any additional changes to your child’s schedule after the first week of School will cost an additional $150 fee*

I understand
Payment Information
I am interested in becoming a family member of Congregation Bnai Avraham, "the fastest growing community in Downtown Brooklyn," and receive 3% off tuition?

Yes
Please return this form with a copy of your child's birth certificate, and a $200 registration fee and/or $1,000 deposit fee. Make check payable to Kiddie Korner Preschool, or you may pay online by completing the following and clicking the submit button at the bottom of the page. Please note that the $1,000 deposit fee is non-refundable with no exceptions.

Payment

Credit Card Paypal eCheck

Postal / Zip Code

Country

$200 $1000 $1200
Your signature and submission of this form indicates that you have read, understood, and agree with the above statements.
Signature*
Should be Empty:

This page uses TLS encryption to keep your data secure.

Program of Interest

Child Information

Parent/Guardian Information

Parental Involvement

Disclaimer

Payment Information

More in this section