Hebrew School Registration

Hebrew School Registration Form 2024-2025
Full Name*

First Name Last Name
How many children are you registering?*
Child 1
Name*

First Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
Jewish Name
School*
Grade entering*
Child 2
Name

First Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Jewish Name
School
Grade entering
Child 3
Name

First Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Jewish Name
School
Grade entering
Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Parents Information
Marital Status*
Parents 1 Information
Parent 1*

First Name Last Name
Parent 1 Jewish by:*

BirthChoice
Parent 1 Cell*

Area Code Phone Number
Parent 1 E-mail*
Parents 2 Information
Parent 2*

First Name Last Name
Parent 2 Jewish by:*

BirthChoice
Parent 2 Cell*

Area Code Phone Number
Parent 2 E-mail*

Family Address*

Emergency contact other than parents
Full Name*

First Name Last Name
Relationship to child?*
Phone Number*
Payment
Tuition is $650. The tuition includes all supplies & a healthy snack.

10% sibling discount will automatically be applied to all registrations of two or more children from the same family.

$100 registration fee is required. This amount will be deducted from the tuition.

Please Note: Chabad has a "no child turned away" policy for any Jewish child that wishes to learn at our Hebrew School, but is lacking funds. Please email [email protected] if you would like to sign up for a scholarship, and we will reach out to you.
I would like to pay the tuition:*

Charge me the full tuition amount todayWith 9 monthly instalments

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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Hebrew School Registration Form 2024-2025