Community Synagogue of Rye
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    2020-2021 Family Information and Photo Waiver - Confidential


    ​Photo Images
    From time to time, The Community Synagogue of Rye and the Early Childhood Center like to publish images of the ECC classes and activities. No child is ever identified without specific permission from a parent. If you would prefer your child
    NOT be pictured.  
    For any question related to membership or the congregation, please contact our Executive Director, Glynis Conyer at gconyer@comsynrye.org or 914-967-6262.
Submit

    ​ALLERGY ALERT FORM

    The purpose of this form is to alert the school of any known allergies.
     
    IMPORTANT NOTE:
    ANY CHILD REQUIRING SPECIAL HEALTHCARE NEEDS OR MEDICATION MUST PROVIDE INFORMATION ON AN ADDITIONAL FORM.
    NO MEDICATION WILL BE ADMINISTERED WITHOUT AN APPROVED MEDICAL CONSENT FORM.

    ​
    Click to download:              Child Medical Statement                    Medical Consent Form                  Non Medical Consent Form                   ​         
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    ECC Emergency Information Card

    If a parent cannot be reached, list 3 local contacts who you would like to be notified. Please indicate each person's relationship to the child.
    Please complete and submit this form before the first day of school.

    EMERGENCY CARD - Permission Statement 

    I give permission to Community Synagogue Early Childhood Center to take emergency measures as judged necessary for the care and protection of my child while under their supervision. 

    In case of medical emergency, I understand that I deemed necessary by the local emergency medical providers (i.e. EMS) my child will be transported to an appropriate medical facility by the local emergency unit. 

    It is understood that in some medical situations, the staff will need to contact the local emergency resource before the parent, child's physician and/or other adult acting on the parent's behalf. 
    ​
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    Child's History


    EARLY DEVELOPMENTAL HISTORY 


    CURRENT PERSONALITY & SOCIAL ADJUSTMENT 

Submit

Community Synagogue of Rye
200 Forest Avenue
Rye, NY 10580

Office: 914-967-6262
Fax: 914-940-6552
info@comsynrye.org

ECC: 914-967-7698
CJL: 914-967-7598

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