Register

Registration for year 2018-2019 is now open!

Please fill out this form as an initial registration for the Chabad Hebrew School.

Confirmation of acceptance will be acknowledged only after this registration form is reviewed and an acceptance letter is received.

To Print Hebrew School Application Form Click Here

First Name*

Last Name*

Hebrew Name

Date of Birth*

MonthDayYear

Age

MaleFemale

Does your child have any previous Jewish Education

YesNo

If yes, please describe

What school does your child attend?

Grade entering:

Is the natural father of the child Jewish?

YesNo

Is the natural mother of the child Jewish?

YesNo

Were there any conversions or adoptions in your family?

YesNo

If yes, please describe

Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential):

Father's Name

Cell Number

Email

Mother's Name

Cell Number

Email

Address

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

Emergency Contact 1

Cell Number

Relationship to child

Emergency Contact 2

Cell Number

Relationship to child

Child's physician or medical facility

Physician's phone

Physician's address

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trip on and beyond school properties and allow my child to be photographed while participating in Chabad Hebrew School activities.

*

AcceptDo not accept

Initial here:

Hebrew School Tuition Agreement

The following is a tuition agreement for the Chabad Hebrew School. The agreement explains the tuition fees, payments plans and refund policies. Please read it through carefully. If paying by check or cash, full payment must be submitted to the school office before any child will be permitted to attend classes.

The tuition for the Chabad Hebrew School is $500.00 per Year per child (this includes a registration & book fee). Membership Not Required.

Discounts: There is a 10% discount off of the regular tuition for each additional child of the same family. There is a 10% additional discount off your total tuition for each child of another family you successfully introduce to the Chabad Hebrew School.

You may choose from the following payment methods:

PLAN A: You may pay the entire amount in full with a check, cash or credit card.PLAN B: You may pay the annual tuition on a monthly basis by submitting 5 checks of $100.00 each, dated September through Jan. All checks must be submitted before the first day of Hebrew School.PLAN C: You may use your credit card to pay the tuition on a monthly basis. Your credit card will be charged $100.00 monthly September - Jan. To do so please include your credit card number and expiration date.

First Taste Program Tuition Agreement

Cost:

A: $425 for complete program

Payments can be made with a check, cash or credit card.

*

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Your FULL name here:

Payment

Credit Card Other

I heard about the Chabad Hebrew School from:

I would like to receive news and updates by email

Student Information

Parents Information

Emergency Contact Information