Register for SMP

Teen Information

First Parent/Guardian Information

Second Parent/Guardian Information

Emergency Contact

Emergency contact (other than parents) in case of illness. This person MUST be able to come and pick up your child.

Health Information

Does your child have any anaphylactic allergies?
Does your child have a prescription for an epi pen?

I give the Education Staff of Adath Jeshurun Congregation permission to communicate in writing and verbally with Talmud Torah of Minneapolis, Sha’arim, HMJDS, Talmud Torah of St. Paul or Torah Academy about my child’s academic progress. This information will be kept confidential and will be used to help plan my child’s learning at Adath.
*Please be sure you have returned your paperwork. If you need additional copy of the paperwork, please contact Darlene Davis the Rabbis’ Assistant at

Please read and sign to show you have read the following:

I give permission for Adath Jeshurun Congregation to use pictures or images of my minor child named in this application in any advertising, marketing, or promotional materials.

We agree as a family to:


Adath Jeshurun celebrates the inclusion of people of all abilities. To discuss your child's needs, please contact Risa Kessler at or 952.215.3925.

Please read and type your name above to show you have read and agreed to the following:

1) SMP is in session from 10 am until 12 pm during the school year beginning September 26, 2020 and running through May 1, 2021 – please note SMP begins at 9:30am on the last day. For your child’s protection, we cannot let SMP students leave SMP or the building without written permission from a parent or guardian. You MUST come in and pick up your child if you have not sent a note.

2) Your child MUST be enrolled and attend either the Heilicher Minneapolis Jewish Day School, Talmud Torah of Minneapolis, Talmud Torah of St. Paul or Torah Academy concurrently with SMP for the entire school year, especially in grades 5 – 7.

3) We require a respectful dress code in keeping with the spirit of Shabbat.

4) We agree as a family to:

Take Care Of Our Environment * Treat with respect all property * Treat with respect other students’ materials and work * Treat with respect all displays on bulletin boards in halls and classrooms

Be Kind to Others * Treat others in the way that you would like to be treated * Show respect and courtesy to all people: especially to our teaching staff

Participate in the Mitzvah Of Studying Torah * We are here to study Torah and learn liturgy * Participate appropriately in class and in Services * Leave all socializing for after class * Be on time

Be Safe * Leaving the synagogue building during the program without permission is against SMP policy * For safety reasons – no running in the halls or roaming through the building and will work toward maintaining a sacred community of learning at SMP.


The fee for grades 5-7 is included in the Bnai Mitzvah Fee (If you did not pay at that time you received your child’s date, you will be billed). For grade 8 it is $195.

Submit Your Response

I understand that by submitting this form, I am agreeing to the terms of enrollment for my child to be in the Adath Jeshurun Shabbat Morning Program for 2020-21 school year. This fee can be paid with a credit card through PayPal. If you would like to set up alternate financial arrangements, please contact Miranda Weisbuch at the Adath office, 952.545.2424. This form is due by Wednesday, Sept. 16, 2020. For your child's registration to be recorded by the system, online payment must be completed, or other arrangements must be made.