Limmud b'Shabbat 5786 / 2025-2026

SF Contact ID

SF Account ID

SF 2nd Account ID

Scholarship Fund Campaign ID

Confirmation of Identity & Membership Status

Thank you for your interest in joining our wonderful Limmud community! We are excited to learn with your child(ren) in the 5786 school year and to dive into the song, art, play, and delights of Jewish values, holidays, and learning. This form will collect all the information we need to make a great experience for you and your child(ren) at Limmud, so thank you for taking the time to carefully go through the whole form. Please reach out to children@cbst.org if you have questions

Please note that you must be a member in good standing (including completion of past-due tuition) in order to have your child's Limmud registration confirmed. If you have questions about your membership status, please contact membership@cbst.org.

Are you a member of CBST?

Yes, I am a member.No, I am not a member, but plan to join for the 5786 year.

Please continue with this form, and once you have joined CBST as a member, your child's Limmud enrollment will be confirmed.

This Limmud registration form is customized for the student listed below.

First Name

Last Name

Please confirm if you are filling out the form for the child listed above.

Yes, I am completing the form for the child above.No, I want to update the information for a child not listed above.

Click this link for a Limmud registration form without any customization to update the information for someone other than the person listed above.

Use Blank Form

Dear Member,

Please complete the information on the following pages. Required fields are marked with an asterisk (*).

It will be easiest to complete this on a computer, but it can be done on a tablet or a phone. We encourage you to notify us of updates anytime by emailing children@cbst.org.

Thank you!

CBST Staff and Clergy

Applicant Information

Student Information

First name:

Middle name:

Last name:

Preferred name:

Please select one:

Hebrew/Jewish name:

Please enter in English transliteration

Date of birth:

Before/after sunset?

Pronouns:

Tell us more:

Student cell (required for Teen Track):

Student email (required for Teen Track):

Optional for younger students; only used by teacher and is not added to any lists or shared

Educational Background

Weekday school name:

Grade in September 2025:

Religious school (other than CBST):

Summer 2025 camp:

Student's special interests/activities:

Commitments that may affect attendance at CBST:

Please share any special learning needs. The information you share remains confidential, used by faculty solely to deliver the highest quality education for each student.

Please upload a copy of child's most recent IEP or GIEP:

Additional information about learning need(s):

Please share any strategies that have been successful in working with this student. What motivates them to be their best selves?

Medical Information

Allergies (please list all applicable allergies).
Please enter N/A if not applicable to this child:

Does student carry an EpiPen?

Does student use an inhaler?

Share medical information that CBST staff and medical professionals should know (e.g., chronic illness, medication taken and avoided, medical devices).
Please enter N/A if not applicable to this child:

Physical limitations (e.g. mobility, visual perception, hearing).
Please enter N/A if not applicable to this child:

Primary doctor/clinic name:

Primary doctor/clinic phone number:

Household Information

If you need to add/change any information below that is non-editable, please let us know in the text box below or email children@cbst.org.

Child resides with:

Adult 1 Information

Adult 1 Contact ID

Adult 1 Account ID

Adult 1 first name:

Adult 1 last name:

Adult 1 pronouns:

Adult 1 - tell us more:

Adult 1 relationship to child:

Name student calls Adult 1:

Adult 1 email address:

Adult 1 cell phone:

Adult 1 street address (include apt #):

Adult 1 city:

Adult 1 state:

Adult 1 ZIP:

Adult 2 Information

Adult 2 Contact ID

Adult 2 Account ID

Adult 2 first name:

Adult 2 last name:

Adult 2 pronouns:

Adult 2 - tell us more:

Adult 2 relationship to child:

Name student calls Adult 2:

Adult 2 email address:

Adult 2 cell phone:

Adult 2 street address (include apt #):

Adult 2 city:

Adult 2 state:

Adult 2 ZIP:

Adult 1 and Adult 2 Accts Match?

Check the box below to add additional adult caregivers who live in the household(s) where the child resides regularly.

Would you like to add additional adult caregivers who reside in the child's household(s)?

Yes, add additional adult caregivers

Additional Adult Information

Click the "Add additional adult" link at the bottom right of this section to add additional adult caregivers who regularly reside in this child's household(s).

Addl Adult Contact ID

Additional adult first name:

Additional adult last name:

Additional adult pronouns:

Additional adult - tell us more:

Additional adult relationship to child:

Name student calls additional adult:

Additional adult email address:

Additional adult cell phone:

This adult resides with:

Additional adult account ID:

Important Family Information

Additional important adults or other family information CBST should know:

Names and birthdates of children in your household NOT currently enrolling:

Significant family events/changes in the past year that CBST should know about (e.g., separation, birth/adoption of a sibling, illness, death, new caregiver, move):

Share a snapshot of Jewish life in your family, such as:
• Celebrations of Shabbat, holidays, etc.
• Affiliation with another Jewish community (synagogue, JCC, etc.)
• Family members who read or speak Hebrew
Please enter N/A if not applicable to this child:

Describe other religions or cultures present in your family/extended family:

Tell us what you most want your child to gain from their experiences at CBST this year:

Authorization

Emergency Contacts

If the adult(s) listed on the previous page cannot be reached, I give permission for CBST to share information regarding my child with the following people:

Name:

Relationship to child:

Phone:

Name:

Relationship to child:

Phone:

Releases

PHOTO/AUDIO/VIDEO/WEBSITE/SOCIAL MEDIA RELEASE:
I give permission for images and audio of my child taken at CBST activities to be used in CBST’s PR/marketing.

YesNo

FAMILY DIRECTORY RELEASE:
I give permission for my contact information to be shared with other parents in my child's class. Our intention is to create a directory for Limmud families only.

YesNo

FIRST AID RELEASE:
I consent to have CBST staff provide general first aid to my child.

EMERGENCY MEDICAL TREATMENT RELEASE:
In case of medical emergency, I authorize CBST staff to follow instructions and permit medical treatment for my child by medical authorities (e.g., 911 operators, emergency medical technicians, hospital and medical facility personnel, physicians). I understand that I am responsible for all such emergency medical costs incurred.

Adult 1 electronic signature:

Adult 1 signature date:

Adult 2 electronic signature:

Adult 2 signature date:

Payment Information

Tuition

Refund Information:

In case of cancellation, CBST cannot provide refunds after October 31, 2025

Grades K, 1, 2, 3, 4, 5
$2,100

Grades 6 & 7 B* Mitzvah Program
$3,000

Teen Track (Grades 8-12)
$2,700

Early bird discount of $150 / student is available until July 31, 2025

Hidden Fields for Early-Bird Pricing

Today's Date

Cutoff Date

Date Difference

Select grade program:

Tuition rate:

$

Payment Options

If you are requesting a monthly installment plan or scholarship, please select that option below in the Payment options dropdown menu.

Payment options:

Payment method:

# Monthly installments:

Amount per installment:

$

Important Scholarship Information

CBST is committed to seeing that no child is denied a Jewish education due to financial circumstances; a limited amount of funding is available for families who need financial support. The scholarship request deadline is August 15, 2025.

We will reach out to you regarding your scholarship request as soon as possible. You must have confirmed your scholarship award before the first day of Limmud in order to have your child's enrollment confirmed.

Please enter below the amount you can contribute monthly toward this student's tuition for the 9 months of the Limmud program.

I can contribute:

$

per month

Tuition contribution total

$

Requested scholarship total:

$

The actual cost of educating our Limmud students exceeds our tuition by over 50%. We invite you to consider contributing this amount as a tax-deductible donation below.

If you selected an installment plan above, the donation will be divided between each payment on your plan.

Please choose one:

Additional 50%:

$

Other amount:

$

Total donation:

$

Donation install

$

Please ensure the amount you are electing to contribute is evenly divisible by the number of installments you chose. Thank you!

Amount to pay today:

$

Payment Information

Billing first name:

Billing last name:

Billing email:

Billing street:

Billing city:

Billing state:

Billing ZIP:

Credit card number:

Exp. MM:

Exp. YY:

CVV:

Bank routing number:

Bank account:

Bank account type:

Bank name:

Account holder name:

Account Name

Learner Contact Id

Authnet_Hidden_Fields

This Month

Academically gifted	ADHD / ADD
Autism Spectrum Disorder	Behavioral needs
Difficulty understanding spoken or written instructions	Dyslexia
English is not student’s primary language	Other (note below)
Student has an IEP or GIEP