We are currently accepting application forms for the 2020-2021 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us. Please be aware that Hebrew School may need to adapt due to health and safety concerns this year.

Please note that one registration form per child is needed.

We look forward to a wonderful year of learning and growth.

Student Profile
 
First Name
Last Name
Hebrew Name
DOB
School

Grade Entering (Fall 2020)
Hebrew Reading Proficiency Low  Average High
General Jewish Knowledge Low  Average High
Please detail your child's previous Jewish education and background
 
Parent Information
 

Father's Name

 
Phone

Mother's Name 
Mother's Hebrew Name

Phone
Address
City
State
Zip
Email Address
Emergency Information
 
Emergency Contact 1
Phone
Emergency Contact 2
Phone

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 as 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 trips on and beyond school properties and allow my child to be photographed while participating in Chabad Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept

Name: Initials: