Registration 2024-25

Home Address*

Religious and Educational History
My Child is*

Jewish from birth - mother is jewishNot JewishConverted
Are there any adoptions in your family (children, parents or grandparents)?*
Have you or your spouse, parents, grandparents or children ever converted to Judaism?*
Does your child read basic Hebrew?*

NoneSomewhatWell
Parents' Information
Father:
Full Name*

First Name LastName
Hebrew Name
Father's E-mail*
Father's Cell Phone*
Work Telephone
Occupation
Name of Work

Address of Work

Address of Work

Emergency Information
Child's Physician*
Physician's Telephone*
Please list any psychological or medical conditions, medications currently being taken, dietary requirements, allergies (include allergies to medications), etc. pertaining to your child.*
Emergency Contact*

First Name Last Name
Relationship to Child*
Phone Number*
Permission for Emergency Medical Treatment*

I hereby give consent to the administration of the Chabad Hebrew School to take whatever medical measures they deem necessary, at my expense, for my child, in the event of a medical emergency.
Parental Consent
Class Trips Consent*

I hereby permit my child to participate in all school activities and to join in class and school trips on and beyond school properties and use any transportation selected by the Chabad Hebrew School.
Photography Consent

I allow my child to be photographed while participating in Chabad Hebrew School activities and that these pictures may be used for marketing purposes.
How did you hear about the Chabad Hebrew School?
Tuition Agreement
Tuition: $1050 *Pay in FULL by Aug 25 and receive a $50 discount per child.

(Includes Registration and Book fee)

*Please note: All fees are non-refundable
Choose from the following payment options:*

# 1: Payment in Full (by August 25, 2024# 2: Pay in two installments. (2/3 of tuition by August 25, 2023 and 1/3 by January 1, 2025Other payment plans arranged with the office
Total

$0.00

Payment

Credit Card Check

Postal / Zip Code

Country

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Educate Your Child... Educate a Generation

Student Information