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Hebrew School Online Registration

Hebrew School Online Registration

Online Registration

Returning Students Please Complete the Form Below

New Students Please Complete The New Student Form First

Child 1. info:

First Name

Last Name
Hebrew Name (if known)
DOB
School
Grade Entering
 
Hebrew Reading Proficiency
Previous Jewish Education

Child 2. info (Optional):

First Name
Last Name
DOB
School
Grade Entering
Hebrew Name (if known)
 
Is the natural mother of the child/ren Jewish? YES NO

Where there any conversions or adoptions in the family? Please explain.

 

Parent Info:

Address
City
Zip
Home Phone
 
Father's Name
Cell Phone
Email
 
Mother's Name
Cell Phone
Email
 

Emergency Info:

Emergency contact 1
Phone
 
Emergency contact 2
Phone
 

Allergies

Does your child/ren has any allergies or other medical conditions we should be aware of?

YES NO

If yes, please share the basics with us

 
 
 
 
 

I/we give permission for my child/ren to to attend all field trips and outings part of the Chabad Hebrew School.

As the parent(s) or legal guardian(s) of the above entered student. I/we authorize any adult acting on behalf of the Chabad Hebrew School to hospitalize or secure treatment for my child/ren. I further agree to pay for all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, The Chabad Hebrew School will try to communicate with me prior to such treatment.
 

Payment Options Per Child:

1 payment of $825 + $25 Registration Fee after July 15th 2016 . Registration Before July 15th 2016 $800 + $25

3 Installments 1. $300 due Sep 1st, 2. $300 Dec 1st, 3. $250 March 1st

You can pay using your Credit Card or check.

Mail check to the Chabad Center of Sudbury, 100 Horse Pond Road Sudbury, MA 01776

Please make checks payable to the Chabad Center of Sudbury and make sure to write Hebrew School and your child's name on the check.

 

1 payment of $850 
3 Part Installment Plan

Check


Card Number

Name on Card

Amount

Expiration Date

CCV

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