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11301 W. Broward Boulevard, Plantation, FL 33325  954-472-3600/ Fax

(Please return a separate form for each child with your Congregational Packet)

If your child is new to Ramat Shalom Torah School, please indicate child’s previous Sunday/Hebrew school experiences.

Emergency Information: In case of minor illness or injury of my child at school, I give the school staff permission to give basic first aid to my child. In case of a major injury or illness, I understand that staff will make every effort to contact me. If they are unable to do so, I give permission for my child’s physician and/or an ambulance to be contacted and for a physician to hospitalize and/or secure proper treatment for my child.

In case of an emergency call:

My child may be picked up from Torah School by the following people:

List any allergies, medical conditions and/or daily medication: (Please notify the Torah School office of any changes)

For example, specific learning issues, special needs, or educational accommodations.