<!DOCTYPE html>

<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
<head>
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="Content-Language" content="en" />

<meta property="og:image" content="https://w2.chabad.org/media/images/1079/Ranj10790698.png" itemprop="image" width="150" height="150" />
<meta property="og:image:width" content="150" />
<meta property="og:image:height" content="150" />
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=0" />
<meta name="keywords" content="5786,Returning,Student,Registration," />
<meta name="title" content="5786 Returning Student Registration - Chabad of Irvine" />
<meta property="og:type" content="website" />
<meta name="scope-aids" content="373303-373311-4681105-1302021-5534637-3739070" />
<meta name="article-keywords" content="16026-2185-20429-6760-8495-7559-2170-2898-20962" />
<meta name="scope-aid" content="373303" />
<meta name="scope-aid" content="373311" />
<meta name="scope-aid" content="4681105" />
<meta name="scope-aid" content="1302021" />
<meta name="scope-aid" content="5534637" />
<meta name="scope-aid" content="3739070" />
<meta name="article-keyword" content="16026" />
<meta name="article-keyword" content="2185" />
<meta name="article-keyword" content="20429" />
<meta name="article-keyword" content="6760" />
<meta name="article-keyword" content="8495" />
<meta name="article-keyword" content="7559" />
<meta name="article-keyword" content="2170" />
<meta name="article-keyword" content="2898" />
<meta name="article-keyword" content="20962" />
<meta property="og:url" content="https://www.chabadirvine.org/templates/articlecco_cdo/aid/3739070/jewish/5786-Returning-Student-Registration.htm" />
<meta property="twitter:card" content="summary_large_image" />
<meta property="twitter:site" content="@chabad" />
<meta property="og:title" content="5786 Returning Student Registration - Chabad of Irvine" /><link rel="canonical" href="https://www.chabadirvine.org/templates/articlecco_cdo/aid/3739070/jewish/5786-Returning-Student-Registration.htm" />
<link rel="icon" type="image/png" href="https://www.chabadirvine.org/media/images/1079/Ranj10790698.png" />
<link rel="Stylesheet" href="/css/fonts/font-awesome/font-awesome-5.css" id="kfont-awesome" type="text/css"/>
<link rel="Stylesheet" href="/css/DefaultGrid.css" id="kgrid" type="text/css"/>
<link rel="Stylesheet" href="/css/Elements.css" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/vendor/ds/tokens/sites.css" id="ksites-ds-css" type="text/css"/>
<link rel="Stylesheet" href="/css/new/main.css" id="k7" type="text/css"/>
<link rel="Stylesheet" href="/css/global.css" id="k3" type="text/css"/>
<link rel="Stylesheet" href="/css/global-print.css" id="k5" type="text/css" media="print"/>
<link rel="Stylesheet" href="/css/cco/home/widget-styles.css" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/sites6/purple-theme.css" id="k" type="text/css"/>
<link rel="Stylesheet" href="https://w2.chabad.org/css/cco/minisites/global.css" id="k20962" type="text/css"/>
<link rel="Stylesheet" href="/css/old/global.css" id="k2898" type="text/css"/>
<link rel="Stylesheet" href="https://w2.chabad.org/images/Shluchim/minisites/themes/hebrew_school/new-styles.css" id="k16026" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/forms/formCss2.css" id="kFormCss" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/forms/themes/nova.css" id="kNova" type="text/css"/>
<link rel="Stylesheet" href="/css/bootstrap/grid.css" id="kbootstrap4-grid" type="text/css"/>
<link rel="Stylesheet" href="/css/Library/reader-comments.css" id="kCommentsStylesheet" type="text/css"/>
<link rel="Stylesheet" href="/css/inline/BookInfo.css" id="kBookInfoCss" type="text/css"/>
<!--[if lte IE 8]> <link rel="Stylesheet" href="/css/global-ie.css" id="k4" type="text/css"/> <![endif]-->
<script>$q=[];$j=function(f){$q.push(f);}</script>
	
<title>
	5786 Returning Student Registration - Chabad of Irvine
</title>
	



<script>
	window.dataLayer = window.dataLayer || [];
	dataLayer.push({"event":"datalayer-initialized","page":{"numberOfComments":0,"publicationDate":"2017-07-26","primaryArticleId":3739070,"title":"","author":"","authorId":0,"contentLevel1":"My Site","contentLevel2":"Children","contentLevel3":"Hebrew School","contentLevel4":"Registration","contentLevel5":"5786 Returning Student Registration ","siteName":"Chabad of Irvine"},"time":{"upcomingHoliday":"The Three Weeks","daysToUpcomingHoliday":1,"hebrewDate":"5786-04-16"}});
		dataLayer.push({ 'articleHierarchy': '-373303-373311-4681105-1302021-5534637-3739070-', 'keywords': '-k20962-k2898-k2170-k7559-k8495-k6760-k20429-k2185-k16026-', 'k': '-373303-373311-4681105-1302021-5534637-3739070--k20962-k2898-k2170-k7559-k8495-k6760-k20429-k2185-k16026-' });
	
</script>
<script>

(function(c,h,a,b,a,d){c[a]=c[a]||[];c[a].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=h.getElementsByTagName(b)[0],
j=h.createElement(b);j.async=true;
j.src='https://w6.chabad.org/mitzvah-tank.js';f.parentNode.insertBefore(j,f);
})(window,document,0,'script','dataLayer');</script>

	<!-- Start of StatCounter Code -->
	<script type="text/javascript">
	var sc_project = 1455931;var sc_partition = 2;var sc_invisible = 1;var sc_remove_link=1;var sc_security = "1f879238";var sc_https = 1;
	</script>
	<script type="text/javascript" src="https://secure.statcounter.com/counter/counter_xhtml.js" defer async></script>
	<noscript><img src="//c3.statcounter.com/counter.php?sc_project=1455931&amp;java=0&amp;security=1f879238&amp;invisible=1" border="0" /> </noscript>
	<!-- End of StatCounter Code -->


<script>
  function ready(fn) {
  if (document.readyState !== 'loading'){
    fn();
  } else {
    document.addEventListener('DOMContentLoaded', fn);
  }
}
function addClass() {
  var path = window.location.pathname;
  var matches = path && path.match(/eventid\/(\d+)/);
  if (path.includes('ArticleCcoResponse')) document.body.classList.add('form-auto-response');
  var aid = Co && Co.ArticleId;
  if (matches && matches.length > 1) {
    var eventClass = 'eventid-' + matches[1];
    document.body.classList.add(eventClass);
    document.body.classList.add('event-page');
 } else if (path.includes('/register_cdo/')) { 
    document.body.classList.add('event-page');
  } else {
    document.body.classList.add('aid-' + aid);
  }
};
ready(addClass);
</script></head>
<body class="lang_en dir_ltr cco_body form secure section_branch sites-article">

	


	
	<div id="PrintCreditHeader" class="show_for_print">
Printed from<b>ChabadIrvine.org</b>
</div>
	<div id="header">
		<div class="wrapper header-wrapper">
			
<div id="feedback_bar" class="hide_for_print no_outline">
	<div class="wrapper">
		
	</div>
</div>

			


<div id="header_container" class="header_container">
	<div class="clearfix links">
		<img src="https://w2.chabad.org/images/global/spacer.gif" width="15" height="8" class="baruch_hashem" />
		<div class="float_right">
			
			
				<div class="topBarLink cco_topbar_link ask_the_rabbi_link">
					<a href="/asktherabbi/default_cdo/jewish/Ask-the-Rabbi.htm">Ask the Rabbi</a>
				</div>
				
			
			
				<div class="topBarLink cco_topbar_link contact_link">
					<a href="/tools/feedback.asp">Contact</a>
				</div>
			
			
		</div>
		<div class="float_left">
			
				<div class="topBarLink cco_topbar_link home_link">
					<a href="/">Home</a>
				</div>
				
			
				<div class="topBarLink cco_topbar_link about_link">
					<a href="/36226">About</a>
				</div>
				
			
			
			
		</div>
	</div>
	<div class="break_floats"></div>
</div>

			<div class="clearfix branding-search">
				<div id="header_branding" class="no_outline  logo">
					<div class="g260 no_margin cco_search_header float_right">
						

<div class="co_search_form margin05">
	<form name="MainSearchForm" id="MainSearchForm" method="get" action="/search/results.asp" class="clearfix" onsubmit="return Co.Forms.Validation.Validate(this, null, {markAsSubmitted:false});">
		<div class="co_global_submit"><button type="submit" class="button" value=" "><span> </span></button></div>
		

<div class="co_global_input_container clearfix">
	<input id="topAreaTopSearch_search" required="true" autocomplete="nope" placeholder="Search" value="" class="co_global_input co_search js-search-field active js-mirrored-input" onblur="this.form.className = this.form.className.replace(/\sactive/gi, &#39;&#39;);" name="searchWord" onfocus="this.form.className+=&#39; active&#39;;" type="text" display_name="Search Field" min_length="3"></input>
</div>

			
		
		
	
		<div id="topAreaTopSearch_search_wrapper" class="co_field_options" style="display:none;">
			<div class="co_absolute_wraper" id="co_absolute_wraper" style="">
				<div class="inner">
					<div id="topAreaTopSearch_search_container" class="co_field_options_suggestions"></div>
					<div class="break_floats"></div>
					
				</div>
			</div>
		</div>
	</form>
</div>
					</div>
					
						<div class="float_left site-logo-wrapper"><a href="/"><img src="https://w2.chabad.org/media/images/1079/Ranj10790698.png" width="100" height="100" border="0"  /></a></div>
					
					<a href="/default.asp" title="Chabad of Irvine" class="site_title">Chabad of Irvine<span class="site_subtitle clearfix"></span></a>
				</div>
			</div>
			
			
			<button type='button' class='cs-mobile-menu-open js-mobile-menu-open'><i class='fa fa-bars'></i></button>
			<div class="site-nav-wrapper">
				<script>
var primaryNavigationVersion = "639184388628054120";
</script>
<div id="co_menu_container_wrapper" class="co_menu_container_wrapper " data-list-name="primary navigation"> 
<div class="co_menu_container clearfix" id="co_menu_container">
<a class="menu_logo" href="/"></a>
<table cellpadding="0" cellspacing="0" border="0" class="main_menu_container first global">
<tr id="tabContentMain" tab="Main" style="display:table-row;">
<td class="co_menu_item home" data-menu-level="1"><a href="/default.asp"><img class="co_menu_home_image" src="https://w2.chabad.org/images/global/spacer.gif" width="28" height="60" border="0" onmouseover="this.className += ' hover';" onmouseout="this.className=this.className.replace(/\s?hover/gi, '');" /></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="1071222" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/articlecco_cdo/aid/7404697/jewish/Womens-Torah-Classes.htm" class="item empty" id="menu_item1-1" data-menu-level="2" data-aid="7404697">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow off" />
<span>Women's Torah Classes</span>
</a>
</div>
<div id="menu_child1-1" class="menu_child empty selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="" class="child_item default" data-menu-level="3" data-aid="0"><span></span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/1071222/jewish/Upcoming-Events.htm" class="parent">Upcoming<br />Events</a></div></span><a href="/templates/articlecco_cdo/aid/1071222/jewish/Upcoming-Events.htm" class="bg_extension js-parent-menu-link" data-aid="1071222"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="4681102" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/articlecco_cdo/aid/1037722/jewish/Synagogue-Services.htm" class="item hover selected" id="menu_item2-1" data-menu-level="2" data-aid="1037722">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Synagogue & Services</span>
</a>
<a href="/templates/section_cdo/aid/2164075/jewish/Chabad-Women.htm" class="item selected" id="menu_item2-2" data-menu-level="2" data-aid="2164075">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Chabad Women</span>
</a>
<a href="/templates/section_cdo/aid/1317824/jewish/Adult-Education.htm" class="item selected" id="menu_item2-3" data-menu-level="2" data-aid="1317824">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Adult Education</span>
</a>
</div>
<div id="menu_child2-1" class="menu_child selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/1385508/jewish/Schedule-of-Services.htm" class="child_item default" data-menu-level="3" data-aid="1385508"><span>Schedule of Services</span></a>
<a href="/templates/articlecco_cdo/aid/373312/jewish/About-Us.htm" class="child_item default" data-menu-level="3" data-aid="373312"><span>About Us</span></a>
<a href="/templates/articlecco_cdo/aid/1038763/jewish/Meet-the-Staff.htm" class="child_item default" data-menu-level="3" data-aid="1038763"><span>Meet the Staff</span></a>
<a href="/templates/articlecco_cdo/aid/3669449/jewish/Kiddush-Sponsorship.htm" class="child_item default" data-menu-level="3" data-aid="3669449"><span>Kiddush Sponsorship</span></a>
<a href="/templates/articlecco_cdo/aid/4646931/jewish/Facility.htm" class="child_item default" data-menu-level="3" data-aid="4646931"><span>Facility</span></a>
<a href="/templates/articlecco_cdo/aid/3745317/jewish/Membership.htm" class="child_item default" data-menu-level="3" data-aid="3745317"><span>Membership</span></a>
<a href="/templates/articlecco_cdo/aid/4650461/jewish/Online-Bill-Pay.htm" class="child_item default" data-menu-level="3" data-aid="4650461"><span>Online Bill Pay</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child2-2" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/2164076/jewish/About.htm" class="child_item default" data-menu-level="3" data-aid="2164076"><span>About</span></a>
<a href="https://web.archive.org/web/20161202123906/http://www.irvinemikveh.org/" class="child_item default" data-menu-level="3" data-aid="3533042"><span>Irvine Community Mikvah</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child2-3" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/1317825/jewish/Classes.htm" class="child_item default" data-menu-level="3" data-aid="1317825"><span>Classes</span></a>
<a href="/templates/articlecco_cdo/aid/1317827/jewish/Womens-Classes.htm" class="child_item default" data-menu-level="3" data-aid="1317827"><span>Women's Classes</span></a>
<a href="/templates/articlecco_cdo/aid/1317828/jewish/Online-Study.htm" class="child_item link" data-menu-level="3" data-aid="1317828"><span>Online Study</span></a>
<a href="/templates/articlecco_cdo/aid/4163954/jewish/Torah-Tuesdays.htm" class="child_item default" data-menu-level="3" data-aid="4163954"><span>Torah Tuesdays</span></a>
<a href="/templates/articlecco_cdo/aid/4913014/jewish/Torah-Studies.htm" class="child_item default" data-menu-level="3" data-aid="4913014"><span>Torah Studies</span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/4681102/jewish/Services.htm" class="parent">Services</a></div></span><a href="/templates/articlecco_cdo/aid/4681102/jewish/Services.htm" class="bg_extension js-parent-menu-link" data-aid="4681102"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="4681105" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/section_cdo/aid/1309144/jewish/Chai-Tots.htm" class="item hover" id="menu_item3-1" data-menu-level="2" data-aid="1309144">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Chai Tots</span>
</a>
<a href="/templates/section_cdo/aid/1302021/jewish/Hebrew-School.htm" class="item" id="menu_item3-2" data-menu-level="2" data-aid="1302021">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Hebrew School</span>
</a>
<a href="/templates/section_cdo/aid/5803459/jewish/Cteen.htm" class="item" id="menu_item3-3" data-menu-level="2" data-aid="5803459">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Cteen</span>
</a>
<a href="/templates/articlecco_cdo/aid/392500/jewish/Youth.htm" class="item" id="menu_item3-4" data-menu-level="2" data-aid="392500">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Youth </span>
</a>
</div>
<div id="menu_child3-1" class="menu_child selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/1309145/jewish/About-Us.htm" class="child_item default" data-menu-level="3" data-aid="1309145"><span>About Us</span></a>
<a href="/templates/articlecco_cdo/aid/1309146/jewish/Curriculum.htm" class="child_item default" data-menu-level="3" data-aid="1309146"><span>Curriculum</span></a>
<a href="/templates/articlecco_cdo/aid/1309148/jewish/Chai-Tots.htm" class="child_item default" data-menu-level="3" data-aid="1309148"><span>Chai Tots</span></a>
<a href="/templates/articlecco_cdo/aid/1309150/jewish/Binie-Babies.htm" class="child_item default" data-menu-level="3" data-aid="1309150"><span>Binie Babies</span></a>
<a href="/templates/articlecco_cdo/aid/5534354/jewish/Kiddy-Camp.htm" class="child_item default" data-menu-level="3" data-aid="5534354"><span>Kiddy Camp</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-2" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/1302022/jewish/About-Us.htm" class="child_item default" data-menu-level="3" data-aid="1302022"><span>About Us</span></a>
<a href="/templates/articlecco_cdo/aid/1302023/jewish/Information.htm" class="child_item default" data-menu-level="3" data-aid="1302023"><span>Information</span></a>
<a href="/templates/articlecco_cdo/aid/1302024/jewish/Curriculum.htm" class="child_item default" data-menu-level="3" data-aid="1302024"><span>Curriculum</span></a>
<a href="/templates/articlecco_cdo/aid/1885453/jewish/Aleph-Champ.htm" class="child_item default" data-menu-level="3" data-aid="1885453"><span>Aleph Champ</span></a>
<a href="/templates/articlecco_cdo/aid/3773139/jewish/Calendar.htm" class="child_item default" data-menu-level="3" data-aid="3773139"><span>Calendar</span></a>
<a href="/templates/articlecco_cdo/aid/5534637/jewish/Registration.htm" class="child_item default" data-menu-level="3" data-aid="5534637"><span>Registration</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-3" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/2661421/jewish/About-Us.htm" class="child_item default" data-menu-level="3" data-aid="2661421"><span>About Us</span></a>
<a href="/templates/articlecco_cdo/aid/5279126/jewish/Photos.htm" class="child_item default" data-menu-level="3" data-aid="5279126"><span>Photos</span></a>
<a href="/templates/articlecco_cdo/aid/5304610/jewish/Events.htm" class="child_item default" data-menu-level="3" data-aid="5304610"><span>Events</span></a>
<a href="/templates/articlecco_cdo/aid/5822041/jewish/Contact-Us.htm" class="child_item default" data-menu-level="3" data-aid="5822041"><span>Contact Us</span></a>
<a href="/templates/articlecco_cdo/aid/5958140/jewish/Donate.htm" class="child_item default" data-menu-level="3" data-aid="5958140"><span>Donate</span></a>
<a href="/templates/articlecco_cdo/aid/6090944" class="child_item default" data-menu-level="3" data-aid="6090944"><span>TEENS AND SEENS </span></a>
<a href="/templates/articlecco_cdo/aid/5780092" class="child_item default" data-menu-level="3" data-aid="5780092"><span>Cteen</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child3-4" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/442209/jewish/Teen-Clubs.htm" class="child_item default" data-menu-level="3" data-aid="442209"><span>Teen Clubs</span></a>
<a href="/templates/articlecco_cdo/aid/452753/jewish/Kids-Club.htm" class="child_item default" data-menu-level="3" data-aid="452753"><span>Kids Club</span></a>
<a href="/templates/articlecco_cdo/aid/3484746/jewish/Upcoming-Events.htm" class="child_item default" data-menu-level="3" data-aid="3484746"><span>Upcoming Events</span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/articlecco_cdo/aid/4681105/jewish/Children.htm" class="parent">Children</a></div></span><a href="/templates/articlecco_cdo/aid/4681105/jewish/Children.htm" class="bg_extension js-parent-menu-link" data-aid="4681105"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item" aid="4652329" data-menu-level="1" onmouseover="this.className += ' hover';" onmouseout="this.className = this.className.replace(/\shover/gi, '');" >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><div><a href="/templates/articlecco_cdo/aid/4652329/jewish/Our-Centers.htm" class="parent">Our<br />Centers</a></div></span><a href="/templates/articlecco_cdo/aid/4652329/jewish/Our-Centers.htm" class="bg_extension js-parent-menu-link" data-aid="4652329"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item" aid="5803466" data-menu-level="1" onmouseover="this.className += ' hover';" onmouseout="this.className = this.className.replace(/\shover/gi, '');" >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><div><a href="/calendar" class="parent">Calendar</a></div></span><a href="/calendar" class="bg_extension js-parent-menu-link" data-aid="5803466"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item donate_link" aid="0" data-menu-level="1" onmouseover="this.className += ' hover';" onmouseout="this.className = this.className.replace(/\shover/gi, '');" >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><div><a href="/4665274" class="parent">Donate</a></div></span><a href="/4665274" class="bg_extension js-parent-menu-link" data-aid="0"></a></td>
</tr>
</table>
</div>
</div>
<!-- END CACHE -->
				<div class="mobile-menu-bottom-links">
					
						<a href="/36226" class="site-menu-general__link">About</a>
					
					<a href="/search">Search</a>
					
						<a href="/tools/feedback.asp">Contact</a>
					
				</div>
			</div>
		</div>
	</div>
	<div id="content">
		<div id="BodyContainer" class="wrapper">
			<div class="body_wrapper   clearfix">
				
	<div class="co_content_container clearfix local_content" id="co_content_container">
		<div class="clearfix">
			<!-- BEGIN HEADER -->

<div id="chabad_body_page">
<div id="chabad_main_content">
<div id="chabad_head">


<div class="chabad_content_head">
<table border="0" cellspacing="0" cellpadding="0" width="100%">
<tbody>
<tr>
<td class="chabad_logo" align="left">
<h1>

<p>
<a href="/1302021">
<img border="0" alt="Chabad Hebrew School" src="https://w2.chabad.org/media/images/977/FJqF9778665.png" real_width="259" real_height="243" width="125" height="117" /></a></p>
</h1>
</td>
<td class="chabad_text_head">

<img border="0" alt="Educate your child... educate a generation!" src="https://w2.chabad.org/images/shluchim/minisites/themes/hebrew_school/hebrew_text_head.png" /></td>
</tr>
</tbody>
</table>
</div>


<div id="navigation" class="chabad_navigator_bar">
<div class="chabad_menu_content">
<ul id="menu" class="navi">
<li class="item parent">
<a href="/article.asp?aid=1302021" class="parent">Home</a>
|
</li>
<li class="item parent">
<a href="/article.asp?aid=1302022" class="parent">About Us</a>
|
</li>
<li class="item parent">
<a href="/article.asp?aid=1302023" class="parent">Information</a>
|
</li>
<li class="item parent">
<a href="/article.asp?aid=1302024" class="parent">Curriculum</a>
|
</li>
<li class="item parent">
<a href="/article.asp?aid=1885453" class="parent">Aleph Champ</a>
|
</li>
<li class="item parent">
<a href="/article.asp?aid=3773139" class="parent">Calendar</a>
|
</li>
<li class="item parent arrow selected">
<a href="/article.asp?aid=5534637" class="parent arrow selected">Registration</a>
<div class="sub_menu">
<ul>
<li class="item first">
<a href="/article.asp?aid=3739089">5786 New Student Registration</a>
</li>
<li class="item last selected">
<a href="/article.asp?aid=3739070">5786 Returning Student Registration </a>
</li>
</ul>
</div>
</li>

</ul>
</div>
</div>

</div>
<div id="chabad_body_content" class="content_full_width">

<div detached="true" class="chabad_left_colum" actions="copy,delete" type="static" name="content_area" id="ContentArea"><div id="content_page_full" class="content_page_full"><!-- END HEADER -->
			
			
			<div class="clearfix bh mobile-only align_right">ב"ה</div>
			
				<div class="master-content-wrapper " >
					

<header class="article-header cf ">
	
	
			<h1 class="article-header__title js-article-title js-page-title">5786 Returning Student Registration </h1>
		
			<div>
				
			</div>
		
</header>
				</div>
			
			<div class="body_wrapper clearfix co_body">
				<div class="" id="co_body_container">
					
					<div id="ContentBody">
						
						
							<div class="content-area-parent no_margin">
								
	<div id="cco_body">
		<div class="content  no_margin no_overflow" id="co_content_container">
			
			
	

	<article class="content js-content" >
	

<div id="formContainer"><script type="text/javascript">var defaultCurrency = { value: 'USD', symbol: '$'};
$j(function(){
window.multiplier = 0;
window.formJson = Object.extend([{"form_height":497,"1_text":"\u003cp style=\"text-align: center;\"\u003eHebrew School Registration - Payment Plans\u003c/p\u003e\u003cp style=\"text-align: center;\"\u003ePlan A: Pay full tuition upfront ($30 discount).\u003c/p\u003e\u003cp style=\"text-align: center;\"\u003ePlan B: Pay in 4 installments by automatically charging credit card\u0026#160;\u003c/p\u003e\u003cp style=\"text-align: center;\"\u003eIf this coming year will be the first time your child is joining us for Hebrew School please fill out our new student form\u0026#160;\u003ca href=\"/Article.asp?AID=3739089\"\u003ehere\u003c/a\u003e.\u003c/p\u003e","1_name":"doubleclickTo","1_qid":1,"1_type":"control_text","1_order":1,"55_text":"Parent Information","55_subHeader":"","55_headerType":"Default","55_name":"clickTo55","55_qid":55,"55_type":"control_head","55_order":2,"4_text":"Parent 1 Full Name","4_message":"","4_labelAlign":"Auto","4_required":"Yes","4_prefix":"No","4_suffix":"No","4_middle":"No","4_description":"","4_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"4_readonly":"No","4_name":"fullName","4_qid":4,"4_type":"control_fullname","4_order":3,"49_text":"Parent 1 Hebrew Name","49_message":"","49_labelAlign":"Auto","49_required":"Yes","49_size":20,"49_validation":"None","49_maxsize":"","49_inputTextMask":"","49_defaultValue":"","49_subLabel":"","49_hint":" ","49_description":"","49_readonly":"No","49_name":"input49","49_qid":49,"49_type":"control_textbox","49_order":4,"44_receivesReceipts":"No","44_text":"Parent 1 E-mail","44_message":"","44_labelAlign":"Auto","44_required":"Yes","44_size":30,"44_validation":"Email","44_maxsize":"","44_defaultValue":"","44_subLabel":"","44_hint":"ex: myname@example.com","44_description":"","44_confirmation":"No","44_confirmationHint":"Confirm Email","44_readonly":"No","44_name":"email","44_qid":44,"44_type":"control_email","44_order":5,"46_text":"Parent 1 Phone Number","46_message":"","46_labelAlign":"Auto","46_required":"Yes","46_validation":"None","46_countryCode":"No","46_inputMask":"enable","46_inputMaskValue":"(###) ###-####","46_description":"","46_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"46_readonly":"No","46_name":"phoneNumber46","46_qid":46,"46_type":"control_phone","46_order":6,"47_text":"Parent 1 Address","47_message":"","47_labelAlign":"Auto","47_required":"Yes","47_selectedCountry":"","47_description":"","47_subfields":"st1|st2|city|state|zip|country","47_sublabels":{"cc_firstName":"First Name","cc_lastName":"Last Name","cc_number":"Credit Card Number","cc_ccv":"Security Code","cc_exp_month":"Expiration Month","cc_exp_year":"Expiration Year","addr_line1":"Street Address","addr_line2":"Street Address Line 2","city":"City","state":"State / Province","postal":"Postal / Zip Code","country":"Country"},"47_name":"address","47_qid":47,"47_type":"control_address","47_order":7,"54_text":"Parent 2 Full Name","54_message":"","54_labelAlign":"Auto","54_required":"Yes","54_prefix":"No","54_suffix":"No","54_middle":"No","54_description":"","54_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"54_readonly":"No","54_name":"fullName54","54_qid":54,"54_type":"control_fullname","54_order":8,"53_text":"Parent 2 Hebrew Name","53_message":"","53_labelAlign":"Auto","53_required":"Yes","53_size":20,"53_validation":"None","53_maxsize":"","53_inputTextMask":"","53_defaultValue":"","53_subLabel":"","53_hint":" ","53_description":"","53_readonly":"No","53_name":"input53","53_qid":53,"53_type":"control_textbox","53_order":9,"52_receivesReceipts":"No","52_text":"Parent 2 E-mail","52_message":"","52_labelAlign":"Auto","52_required":"Yes","52_size":30,"52_validation":"Email","52_maxsize":"","52_defaultValue":"","52_subLabel":"","52_hint":"ex: myname@example.com","52_description":"","52_confirmation":"No","52_confirmationHint":"Confirm Email","52_readonly":"No","52_name":"email52","52_qid":52,"52_type":"control_email","52_order":10,"51_text":"Parent 2 Phone Number","51_message":"","51_labelAlign":"Auto","51_required":"Yes","51_validation":"None","51_countryCode":"No","51_inputMask":"enable","51_inputMaskValue":"(###) ###-####","51_description":"","51_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"51_readonly":"No","51_name":"phoneNumber51","51_qid":51,"51_type":"control_phone","51_order":11,"50_text":"Parent 2 Address","50_message":"","50_labelAlign":"Auto","50_required":"Yes","50_selectedCountry":"","50_description":"","50_subfields":"st1|st2|city|state|zip|country","50_sublabels":{"cc_firstName":"First Name","cc_lastName":"Last Name","cc_number":"Credit Card Number","cc_ccv":"Security Code","cc_exp_month":"Expiration Month","cc_exp_year":"Expiration Year","addr_line1":"Street Address","addr_line2":"Street Address Line 2","city":"City","state":"State / Province","postal":"Postal / Zip Code","country":"Country"},"50_name":"address50","50_qid":50,"50_type":"control_address","50_order":12,"56_text":"Children Information","56_subHeader":"","56_headerType":"Default","56_name":"clickTo56","56_qid":56,"56_type":"control_head","56_order":13,"43_text":"Number of Children Registering","43_message":"","43_labelAlign":"Auto","43_required":"Yes","43_size":5,"43_maxsize":"","43_minValue":"","43_maxValue":"3","43_defaultValue":"","43_subLabel":"","43_hint":"ex: 2","43_description":"","43_readonly":"No","43_pricePerItem":0,"43_name":"number","43_qid":43,"43_type":"control_number","43_order":14,"7_text":"Child 1 Full Name","7_message":"","7_labelAlign":"Auto","7_required":"Yes","7_prefix":"No","7_suffix":"No","7_middle":"No","7_description":"","7_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"7_readonly":"No","7_name":"fullName7","7_qid":7,"7_type":"control_fullname","7_order":15,"23_text":"Child\u0027s Hebrew Name","23_message":"","23_labelAlign":"Auto","23_required":"Yes","23_size":20,"23_validation":"None","23_maxsize":"","23_inputTextMask":"","23_defaultValue":"","23_subLabel":"","23_hint":" ","23_description":"","23_readonly":"No","23_name":"input23","23_qid":23,"23_type":"control_textbox","23_order":16,"8_text":"Grade Entering as of 9/25","8_message":"","8_labelAlign":"Auto","8_required":"Yes","8_size":20,"8_validation":"None","8_maxsize":"","8_inputTextMask":"","8_defaultValue":"","8_subLabel":"","8_hint":" ","8_description":"","8_readonly":"No","8_name":"input8","8_qid":8,"8_type":"control_textbox","8_order":17,"40_text":"Birth Date","40_message":"","40_labelAlign":"Auto","40_required":"Yes","40_format":"mmddyyyy","40_yearFrom":"","40_yearTo":"","40_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"40_description":"","40_sublabels":{"month":"Month","day":"Day","year":"Year"},"40_name":"birthDate","40_qid":40,"40_type":"control_birthdate","40_order":18,"5_text":"Child 2 Full Name","5_message":"","5_labelAlign":"Auto","5_required":"Yes","5_prefix":"No","5_suffix":"No","5_middle":"No","5_description":"","5_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"5_readonly":"No","5_name":"fullName5","5_qid":5,"5_type":"control_fullname","5_order":19,"24_text":"Child\u0027s Hebrew Name","24_message":"","24_labelAlign":"Auto","24_required":"Yes","24_size":20,"24_validation":"None","24_maxsize":"","24_inputTextMask":"","24_defaultValue":"","24_subLabel":"","24_hint":" ","24_description":"","24_readonly":"No","24_name":"input24","24_qid":24,"24_type":"control_textbox","24_order":20,"9_text":"Grade Entering as of 9/25","9_message":"","9_labelAlign":"Auto","9_required":"Yes","9_size":20,"9_validation":"None","9_maxsize":"","9_inputTextMask":"","9_defaultValue":"","9_subLabel":"","9_hint":" ","9_description":"","9_readonly":"No","9_name":"input9","9_qid":9,"9_type":"control_textbox","9_order":21,"41_text":"Birth Date","41_message":"","41_labelAlign":"Auto","41_required":"Yes","41_format":"mmddyyyy","41_yearFrom":"","41_yearTo":"","41_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"41_description":"","41_sublabels":{"month":"Month","day":"Day","year":"Year"},"41_name":"birthDate41","41_qid":41,"41_type":"control_birthdate","41_order":22,"6_text":"Child 3 Full Name","6_message":"","6_labelAlign":"Auto","6_required":"Yes","6_prefix":"No","6_suffix":"No","6_middle":"No","6_description":"","6_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"6_readonly":"No","6_name":"fullName6","6_qid":6,"6_type":"control_fullname","6_order":23,"25_text":"Child\u0027s Hebrew Name","25_message":"","25_labelAlign":"Auto","25_required":"Yes","25_size":20,"25_validation":"None","25_maxsize":"","25_inputTextMask":"","25_defaultValue":"","25_subLabel":"","25_hint":" ","25_description":"","25_readonly":"No","25_name":"input25","25_qid":25,"25_type":"control_textbox","25_order":24,"10_text":"Grade Entering as of 9/25","10_message":"","10_labelAlign":"Auto","10_required":"Yes","10_size":20,"10_validation":"None","10_maxsize":"","10_inputTextMask":"","10_defaultValue":"","10_subLabel":"","10_hint":" ","10_description":"","10_readonly":"No","10_name":"input10","10_qid":10,"10_type":"control_textbox","10_order":25,"42_text":"Birth Date","42_message":"","42_labelAlign":"Auto","42_required":"Yes","42_format":"mmddyyyy","42_yearFrom":"","42_yearTo":"","42_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"42_description":"","42_sublabels":{"month":"Month","day":"Day","year":"Year"},"42_name":"birthDate42","42_qid":42,"42_type":"control_birthdate","42_order":26,"30_text":"Emergency Information","30_subHeader":"(new addition to all registrations)","30_headerType":"Default","30_name":"clickTo","30_qid":30,"30_type":"control_head","30_order":27,"31_text":"Emergency Contact 1","31_message":"","31_labelAlign":"Auto","31_required":"Yes","31_prefix":"No","31_suffix":"No","31_middle":"No","31_description":"","31_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"31_readonly":"No","31_name":"fullName31","31_qid":31,"31_type":"control_fullname","31_order":28,"32_text":"Contact 1 Phone Number","32_message":"","32_labelAlign":"Auto","32_required":"Yes","32_validation":"Numeric","32_countryCode":"No","32_inputMask":"disable","32_inputMaskValue":"(###) ###-####","32_description":"","32_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"32_readonly":"No","32_name":"phoneNumber","32_qid":32,"32_type":"control_phone","32_order":29,"33_text":"Emergency Contact 2","33_message":"","33_labelAlign":"Auto","33_required":"No","33_prefix":"No","33_suffix":"No","33_middle":"No","33_description":"","33_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"33_readonly":"No","33_name":"fullName33","33_qid":33,"33_type":"control_fullname","33_order":30,"34_text":"Contact 2 Phone Number","34_message":"","34_labelAlign":"Auto","34_required":"No","34_validation":"Numeric","34_countryCode":"No","34_inputMask":"disable","34_inputMaskValue":"(###) ###-####","34_description":"","34_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"34_readonly":"No","34_name":"phoneNumber34","34_qid":34,"34_type":"control_phone","34_order":31,"37_text":"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.","37_message":"","37_labelAlign":"Auto","37_required":"No","37_cols":40,"37_rows":"4","37_validation":"None","37_entryLimit":"None-0","37_maxsize":"","37_defaultValue":"","37_subLabel":"","37_hint":"","37_description":"","37_readonly":"No","37_wysiwyg":"Disable","37_name":"input37","37_qid":37,"37_type":"control_textarea","37_order":32,"35_text":"","35_subHeader":"As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of the 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, the 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 the Chabad Hebrew School activities and that these pictures may be used for marketing purposes.","35_headerType":"Default","35_name":"clickTo35","35_qid":35,"35_type":"control_head","35_order":33,"36_text":"I agree to the above:","36_message":"","36_labelAlign":"Auto","36_required":"Yes","36_prefix":"No","36_suffix":"No","36_middle":"No","36_description":"","36_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"36_readonly":"No","36_name":"fullName36","36_qid":36,"36_type":"control_fullname","36_order":34,"11_text":"\u003cp style=\"text-align: center;\"\u003e\u003cb\u003e\u003cfont color=\"#ff0000\" size=\"4\"\u003e\u003cu\u003ePRICING FOR 2025/2026\u003c/u\u003e\u003c/font\u003e\u003c/b\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: center;\"\u003e\u003cstrong\u003eInformation and Payment\u003c/strong\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: center;\"\u003e\u003cfont color=\"#ff0000\"\u003e\u003cu\u003e\u003cstrong\u003eMembers:\u0026nbsp;\u003c/strong\u003e\u003c/u\u003e\u0026nbsp;$850/ year\u003c/font\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: center;\"\u003e\u003cfont color=\"#ff0000\"\u003e\u003cu\u003e\u003cstrong\u003eNon-Members:\u0026nbsp;\u003c/strong\u003e\u003c/u\u003e\u0026nbsp;$1100/ year\u003c/font\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: center;\"\u003e\u003cu\u003e\u003cstrong\u003eFamily Discount:\u0026nbsp;\u003c/strong\u003e\u003c/u\u003e\u0026nbsp;10% off each additional child\u003c/p\u003e\n\n\u003cp style=\"text-align: center;\"\u003e\u003cu\u003e\u003cstrong\u003eTuition Paid in Full $30 Discount per child\u0026nbsp;\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: center;\"\u003eRegistration fee\u0026nbsp;$100\u0026nbsp;per child\u003c/p\u003e\n\n\n","11_name":"doubleclickTo11","11_qid":11,"11_type":"control_text","11_order":35,"38_text":"Registration Fee","38_message":"$100/Child","38_labelAlign":"Auto","38_required":"Yes","38_options":"$100 - One Child|$200 - Two Children|$300 - Three Children","38_special":"None","38_allowOther":"No","38_otherText":"Other","38_calculateOther":"No","38_selected":"","38_spreadCols":"1","38_description":"","38_name":"input38","38_qid":38,"38_type":"control_radio","38_order":36,"38_pricing":"100|200|300","39_text":"Please select:","39_message":"","39_labelAlign":"Auto","39_required":"Yes","39_options":"Member: 1 child: payment in full $820|Member: 1 child: 4 payments $205*|Member: 2 children: payment in full $1558 (with 10% discount on second registration)|Member: 2 children: 4 payments $389.50*|Member: 3 children: payment in full $2296 (with 10% discount on second and third registration)|Member: 3 children: 4 payments $574*|Non Member pricing: 1 child: payment in full $1070|Non Member pricing: 1 child: 4 payments $267.50*|Non Member pricing: 2 children: payment in full $2033 (with 10% discount on second registration)|Non Member pricing: 2 children: 4 payments $508.25*|Non Member pricing: 3 children: payment in full $2996 (with 10% discount on second and third registration)|Non Member pricing: 3 children: 4 payments $749*","39_special":"None","39_allowOther":"No","39_otherText":"Other","39_calculateOther":"No","39_selected":"","39_spreadCols":"1","39_description":"","39_name":"input39","39_qid":39,"39_type":"control_radio","39_order":37,"39_pricing":"820|205|1558|389.50|2296|574|1070|267.50|2033|508.25|2996|749","12_text":"Member Pricing","12_message":"","12_labelAlign":"Auto","12_required":"No","12_options":"1 Child, full upfront: $820 (with discount)|1 child: 4 payments $205|2 Children, full upfront: $1585 (with discount)|2 children: 4 payments $389.50|3 children: payment in full $2296 (with 10% discount on second and third registration)|3 children: 4 payments $574","12_special":"None","12_allowOther":"No","12_otherText":"Other","12_calculateOther":"No","12_spreadCols":"1","12_selected":"","12_minSelection":"","12_maxSelection":"","12_description":"","12_name":"input12","12_qid":12,"12_type":"control_checkbox","12_order":38,"12_pricing":"820|205|1585|389.50|2296|574","12_hidden":"Yes","28_text":"Non-Member Pricing","28_message":"","28_labelAlign":"Auto","28_required":"No","28_options":"1 Child, full upfront: $1070 (with discount)|1 child: 4 payments $267.50|2 children: payment in full $2033 (with discount)|2 children: 4 payments $508.25|3 children: payment in full $2996 (with discount)|3 children: 4 payments $749","28_special":"None","28_allowOther":"No","28_otherText":"Other","28_calculateOther":"No","28_spreadCols":"1","28_selected":"","28_minSelection":"","28_maxSelection":"","28_description":"","28_name":"input28","28_qid":28,"28_type":"control_checkbox","28_order":39,"28_pricing":"1070|267.50|2033|508.25|2996|749","28_hidden":"Yes","13_labelAlign":"Auto","13_text":"Total","13_partialPayEnabled":"No","13_partialPayType":"dollar","13_partialPayMinimum":0,"13_required":"No","13_offsetGiftEnabled":"Yes","13_offsetGift":"3","13_name":"total","13_qid":13,"13_type":"control_totalamount","13_order":40,"14_text":"Payment","14_message":"","14_labelAlign":"Auto","14_required":"No","14_duplicatable":false,"14_selectedCountry":"","14_description":"","14_sublabels":{"cc_firstName":"First Name","cc_lastName":"Last Name","cc_type":"Credit Card Type","cc_number":"Credit Card Number","cc_ccv":"Security Code","cc_nameOnCard":"Name on Card","cc_IdNumber":"Israel Identity Number","cc_exp_month":"Expiration Month","cc_exp_year":"Expiration Year","eCheck_bankName":"Bank Name","eCheck_routingNumber":"Routing Number","eCheck_accountNumber":"Account Number","eCheck_accountType":"Account Type","addr_line1":"Street Address","addr_line2":"Street Address Line 2","city":"City","state":"State / Province","postal":"Postal / Zip Code","country":"Country"},"14_name":"payment","14_qid":14,"14_type":"control_payform","14_order":41,"14_options":{"currency":"default","creditCard":{"value":"Credit Card","enabled":true,"fields":[{"name":"ccv","value":"CCV","enabled":true},{"name":"nameOnCard","value":"Name on Card","enabled":true},{"name":"billingAddress","value":"Billing Address","enabled":true},{"name":"israelIdentityNumber","value":"Israel Identity Number","enabled":true}],"processorIndex":0,"type":[{"name":"Visa","value":"Visa","enabled":true},{"name":"Mastercard","value":"MasterCard","enabled":true},{"name":"Amex","value":"American Express","enabled":true},{"name":"Discover","value":"Discover","enabled":true},{"name":"Isracard","value":"Isracard","enabled":false}],"payMe":false},"paypal":{"value":"Paypal","enabled":false,"processorIndex":null},"eCheck":{"value":"eCheck","enabled":false},"other":{"value":"Other","enabled":false,"altText":"Check","message":"If you like to pay by check please contact me to discuss this payment plan."}},"27_text":"Questions/Comments:","27_message":"","27_labelAlign":"Auto","27_required":"No","27_cols":40,"27_rows":6,"27_validation":"None","27_entryLimit":"None-0","27_maxsize":"","27_defaultValue":"","27_subLabel":"","27_hint":"","27_description":"","27_readonly":"No","27_wysiwyg":"Disable","27_name":"input27","27_qid":27,"27_type":"control_textarea","27_order":42,"18_text":"\u003cp\u003eAs 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. If for any reason you decide to cancel during the year, you will be refunded/ not charged from the beginning of the next month. There are no refunds after May 1st.\u0026#160;I understand that by receiving the early bird discount my first payment is non-refundable.\u003c/p\u003e","18_name":"doubleclickTo18","18_qid":18,"18_type":"control_text","18_order":43,"19_text":"Name","19_message":"","19_labelAlign":"Auto","19_required":"Yes","19_size":20,"19_validation":"None","19_maxsize":"","19_inputTextMask":"","19_defaultValue":"","19_subLabel":"","19_hint":" ","19_description":"","19_readonly":"No","19_name":"input19","19_qid":19,"19_type":"control_textbox","19_order":44,"20_text":"Date","20_message":"","20_labelAlign":"Auto","20_required":"Yes","20_size":20,"20_validation":"None","20_maxsize":"","20_inputTextMask":"","20_defaultValue":"","20_subLabel":"","20_hint":" ","20_description":"","20_readonly":"No","20_name":"input20","20_qid":20,"20_type":"control_textbox","20_order":45,"26_text":"FOR OFFICE USE ONLY","26_message":"","26_labelAlign":"Auto","26_required":"No","26_options":"CMS|Communicator|Attendance Roster|Sign-In Sheet|School Roster (On Drive)|Billing","26_special":"None","26_allowOther":"No","26_otherText":"Other","26_calculateOther":"No","26_spreadCols":"2","26_selected":"","26_minSelection":"","26_maxSelection":"","26_description":"","26_name":"input26","26_qid":26,"26_type":"control_checkbox","26_order":46,"26_pricing":"0|0|0|0|0|0","26_hidden":"Yes","45_text":"Optin","45_labelAlign":"Auto","45_description":"","45_required":"No","45_list":"-1","45_duplicatable":false,"45_name":"optin","45_qid":45,"45_type":"control_optin","45_order":47,"2_text":"Submit","2_buttonAlign":"Center","2_clear":"No","2_print":"No","2_name":"submit","2_qid":2,"2_type":"control_button","2_order":48,"form_title":"Registration Form","form_pagetitle":"Form","form_styles":"nova","form_font":"","form_fontsize":"14","form_fontcolor":"","form_optioncolor":"","form_lineSpacing":"12","form_background":"","form_formWidth":"765","form_labelWidth":"150","form_alignment":"Left","form_thankurl":"","form_thanktext":"","form_highlightLine":"Enabled","form_activeRedirect":"default","form_sendpostdata":"No","form_unique":"None","form_uniqueField":"\u003cField Id\u003e","form_status":"Enabled","form_injectCSS":"","form_hideMailEmptyFields":"disable","form_showProgressBar":"disable","form_formStrings":[{"alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","confirmClearForm":"Are you sure you want to clear the form?","confirmEmail":"E-mail does not match","email":"Enter a valid e-mail address","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxSelectionsError":"The maximum number of selections allowed is","minSelectionsError":"The minimum required number of selections is","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","numeric":"This field can only contain numeric values","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","submissionLimit":"Sorry! Only one entry is allowed.  Multiple submissions are disabled for this form.","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:"}],"form_limitSubmission":"No Limit","form_expireDate":"No Limit","form_messageOfLimitedForm":"This form is currently unavailable!","form_emails":[],"form_language":"","form_sendEmail":"Yes","form_style":"Default","form_theme":"nova","form_id":3739070,"form_stopHighlight":"Yes","form_formStringsChanged":"yes","form_slug":3739070,"form_conditions":[{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"1"}],"actions":[{"field":"5","visibility":"Show"},{"field":"24","visibility":"Show"},{"field":"9","visibility":"Show"},{"field":"41","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"2"}],"actions":[{"field":"6","visibility":"Show"},{"field":"25","visibility":"Show"},{"field":"10","visibility":"Show"},{"field":"42","visibility":"Show"}]}]}][0] || {}, window.formJson || {});
window.isSecureForm = true
});

			if (typeof(Userform) ==='undefined')
			{
				Userform={init:function(args){
					$j(function(){
						Userform.init.apply(Userform, [args]);
					})
				},
				setConditions:function(args){
					$j(function(){
						Userform.setConditions.apply(Userform, [args]);
					})
				}};
			}
</script><script src="/net/platform/sitecontrol/admin/publishing/formbuilder/js/vendor/jquery-1.8.0.min.js?v=null" type="text/javascript"></script>
<script src="/net/platform/sitecontrol/admin/publishing/formbuilder/js/vendor/maskedinput.min.js?v=null" type="text/javascript"></script>
<script type="text/javascript">
   Userform.setConditions([{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"1"}],"actions":[{"field":"5","visibility":"Show"},{"field":"24","visibility":"Show"},{"field":"9","visibility":"Show"},{"field":"41","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"2"}],"actions":[{"field":"6","visibility":"Show"},{"field":"25","visibility":"Show"},{"field":"10","visibility":"Show"},{"field":"42","visibility":"Show"}]}]);
   Userform.init(function(){
      $('input_44').hint('ex: myname@example.com');
      Userform.setPhoneMaskingValidator( 'input_46_full', '(###) ###-####' );
      $('input_52').hint('ex: myname@example.com');
      Userform.setPhoneMaskingValidator( 'input_51_full', '(###) ###-####' );
      $('input_43').hint('ex: 2');
      Userform.alterTexts({"alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","confirmClearForm":"Are you sure you want to clear the form?","confirmEmail":"E-mail does not match","email":"Enter a valid e-mail address","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxSelectionsError":"The maximum number of selections allowed is","minSelectionsError":"The minimum required number of selections is","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","numeric":"This field can only contain numeric values","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","submissionLimit":"Sorry! Only one entry is allowed.  Multiple submissions are disabled for this form.","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:"});
   });
</script>
<style type="text/css" id="GenFormStyles">
    .form-label{
        width:150px !important;
    }
    .form-label-left{
        width:150px !important;
    }
    .form-line{
        padding-top:12px;
        padding-bottom:12px;
    }
    .form-label-right{
        width:150px !important;
    }
    .form-all {
        font-size:14px;
    }
.co_body .content .form-all p {
 font-size:14px;

}
@media screen and (max-width: 600px) {.form-label-left{	float:none;	display:block;}.form-buttons-wrapper.button-align-auto{text-indent: 0!important;}}</style>

<form class="userform-form" action="" method="post" name="form_3739070" id="3739070" accept-charset="utf-8"><input type="hidden" name="formID" value="3739070" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li class="form-line" id="id_1"><div id="cid_1" class="form-input-wide"> <div id="text_1" class="form-html"><p style="text-align: center;">Hebrew School Registration - Payment Plans</p><p style="text-align: center;">Plan A: Pay full tuition upfront ($30 discount).</p><p style="text-align: center;">Plan B: Pay in 4 installments by automatically charging credit card </p><p style="text-align: center;">If this coming year will be the first time your child is joining us for Hebrew School please fill out our new student form <a href="/Article.asp?AID=3739089">here</a>.</p></div> </div></li><li id="cid_55" class="form-input-wide"> <div class="form-header-group"><h2 id="header_55" class="form-header">Parent Information</h2></div> </li><li class="form-line" id="id_4"><div class="form-label-left" id="label_4"><label for="input_4"> Parent 1 Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_4"> </label></div><div id="cid_4" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q4_fullName[first]" id="first_4" autocomplete="given-name" />  <label class="form-sub-label" for="first_4" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q4_fullName[last]" id="last_4" autocomplete="family-name" />  <label class="form-sub-label" for="last_4" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_49"><div class="form-label-left" id="label_49"><label for="input_49"> Parent 1 Hebrew Name<span class="form-required">*</span> </label><label class="label-message" for="input_49"> </label></div><div id="cid_49" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_49" name="q49_input49" size="20" value="" /> </div></li><li class="form-line" id="id_44"><div class="form-label-left" id="label_44"><label for="input_44"> Parent 1 E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_44"> </label></div><div id="cid_44" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_44" name="q44_email" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_46"><div class="form-label-left" id="label_46"><label for="input_46"> Parent 1 Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_46"> </label></div><div id="cid_46" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input data-type="mask-number" class="mask-phone-number form-textbox validate[required]" type="tel" name="q46_phoneNumber46[full]" id="input_46_full" autocomplete="tel" />  <label class="form-sub-label" for="input_46_full"><span> </span></label></span></div> </div></li><li class="form-line" id="id_47"><div class="form-label-left" id="label_47"><label for="input_47"> Parent 1 Address<span class="form-required">*</span> </label><label class="label-message" for="input_47"> </label></div><div id="cid_47" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q47_address[addr_line1]" id="input_47_addr_line1" size="46" autocomplete="address-line1" />  <label class="form-sub-label" for="input_47_addr_line1" id="sublabel_47_addr_line1">Street Address</label></span></td></tr><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line no-validation" type="text" name="q47_address[addr_line2]" id="input_47_addr_line2" size="46" autocomplete="address-line2" />  <label class="form-sub-label" for="input_47_addr_line2" id="sublabel_47_addr_line2">Street Address Line 2</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q47_address[city]" id="input_47_city" size="21" autocomplete="address-level2" />  <label class="form-sub-label" for="input_47_city" id="sublabel_47_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q47_address[state]" id="input_47_state" size="22" autocomplete="address-level1" />  <label class="form-sub-label" for="input_47_state" id="sublabel_47_state">State / Province</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q47_address[postal]" id="input_47_postal" size="10" autocomplete="postal-code" />  <label class="form-sub-label" for="input_47_postal" id="sublabel_47_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q47_address[country]" id="input_47_country" autocomplete="country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_47_country" id="sublabel_47_country">Country</label></span></td></tr></tbody></table> </div></li><li class="form-line" id="id_54"><div class="form-label-left" id="label_54"><label for="input_54"> Parent 2 Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_54"> </label></div><div id="cid_54" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q54_fullName54[first]" id="first_54" autocomplete="given-name" />  <label class="form-sub-label" for="first_54" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q54_fullName54[last]" id="last_54" autocomplete="family-name" />  <label class="form-sub-label" for="last_54" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_53"><div class="form-label-left" id="label_53"><label for="input_53"> Parent 2 Hebrew Name<span class="form-required">*</span> </label><label class="label-message" for="input_53"> </label></div><div id="cid_53" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_53" name="q53_input53" size="20" value="" /> </div></li><li class="form-line" id="id_52"><div class="form-label-left" id="label_52"><label for="input_52"> Parent 2 E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_52"> </label></div><div id="cid_52" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_52" name="q52_email52" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_51"><div class="form-label-left" id="label_51"><label for="input_51"> Parent 2 Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_51"> </label></div><div id="cid_51" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input data-type="mask-number" class="mask-phone-number form-textbox validate[required]" type="tel" name="q51_phoneNumber51[full]" id="input_51_full" autocomplete="tel" />  <label class="form-sub-label" for="input_51_full"><span> </span></label></span></div> </div></li><li class="form-line" id="id_50"><div class="form-label-left" id="label_50"><label for="input_50"> Parent 2 Address<span class="form-required">*</span> </label><label class="label-message" for="input_50"> </label></div><div id="cid_50" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q50_address50[addr_line1]" id="input_50_addr_line1" size="46" autocomplete="address-line1" />  <label class="form-sub-label" for="input_50_addr_line1" id="sublabel_50_addr_line1">Street Address</label></span></td></tr><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line no-validation" type="text" name="q50_address50[addr_line2]" id="input_50_addr_line2" size="46" autocomplete="address-line2" />  <label class="form-sub-label" for="input_50_addr_line2" id="sublabel_50_addr_line2">Street Address Line 2</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q50_address50[city]" id="input_50_city" size="21" autocomplete="address-level2" />  <label class="form-sub-label" for="input_50_city" id="sublabel_50_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q50_address50[state]" id="input_50_state" size="22" autocomplete="address-level1" />  <label class="form-sub-label" for="input_50_state" id="sublabel_50_state">State / Province</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q50_address50[postal]" id="input_50_postal" size="10" autocomplete="postal-code" />  <label class="form-sub-label" for="input_50_postal" id="sublabel_50_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q50_address50[country]" id="input_50_country" autocomplete="country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_50_country" id="sublabel_50_country">Country</label></span></td></tr></tbody></table> </div></li><li id="cid_56" class="form-input-wide"> <div class="form-header-group"><h2 id="header_56" class="form-header">Children Information</h2></div> </li><li class="form-line" id="id_43"><div class="form-label-left" id="label_43"><label for="input_43"> Number of Children Registering<span class="form-required">*</span> </label><label class="label-message" for="input_43"> </label></div><div id="cid_43" class="form-input"> <input type="number" class="form-number-input  form-textbox validate[required]" id="input_43" name="q43_number" style="width:60px" size="5" value="" data-type="input-number" autocomplete="nope" min="0" data-numbermin="0" max="3" data-numbermax="3" /> </div></li><li class="form-line" id="id_7"><div class="form-label-left" id="label_7"><label for="input_7"> Child 1 Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_7"> </label></div><div id="cid_7" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q7_fullName7[first]" id="first_7" autocomplete="given-name" />  <label class="form-sub-label" for="first_7" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q7_fullName7[last]" id="last_7" autocomplete="family-name" />  <label class="form-sub-label" for="last_7" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_23"><div class="form-label-left" id="label_23"><label for="input_23"> Child's Hebrew Name<span class="form-required">*</span> </label><label class="label-message" for="input_23"> </label></div><div id="cid_23" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_23" name="q23_input23" size="20" value="" /> </div></li><li class="form-line" id="id_8"><div class="form-label-left" id="label_8"><label for="input_8"> Grade Entering as of 9/25<span class="form-required">*</span> </label><label class="label-message" for="input_8"> </label></div><div id="cid_8" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_8" name="q8_input8" size="20" value="" /> </div></li><li class="form-line" id="id_40"><div class="form-label-left" id="label_40"><label for="input_40"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_40"> </label></div><div id="cid_40" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q40_birthDate[month]" id="input_40_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_40_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q40_birthDate[day]" id="input_40_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_40_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q40_birthDate[year]" id="input_40_year"><option></option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_40_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_5"><div class="form-label-left" id="label_5"><label for="input_5"> Child 2 Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_5"> </label></div><div id="cid_5" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q5_fullName5[first]" id="first_5" autocomplete="given-name" />  <label class="form-sub-label" for="first_5" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q5_fullName5[last]" id="last_5" autocomplete="family-name" />  <label class="form-sub-label" for="last_5" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_24"><div class="form-label-left" id="label_24"><label for="input_24"> Child's Hebrew Name<span class="form-required">*</span> </label><label class="label-message" for="input_24"> </label></div><div id="cid_24" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_24" name="q24_input24" size="20" value="" /> </div></li><li class="form-line" id="id_9"><div class="form-label-left" id="label_9"><label for="input_9"> Grade Entering as of 9/25<span class="form-required">*</span> </label><label class="label-message" for="input_9"> </label></div><div id="cid_9" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_9" name="q9_input9" size="20" value="" /> </div></li><li class="form-line" id="id_41"><div class="form-label-left" id="label_41"><label for="input_41"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_41"> </label></div><div id="cid_41" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q41_birthDate41[month]" id="input_41_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_41_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q41_birthDate41[day]" id="input_41_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_41_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q41_birthDate41[year]" id="input_41_year"><option></option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_41_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_6"><div class="form-label-left" id="label_6"><label for="input_6"> Child 3 Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_6"> </label></div><div id="cid_6" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q6_fullName6[first]" id="first_6" autocomplete="given-name" />  <label class="form-sub-label" for="first_6" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q6_fullName6[last]" id="last_6" autocomplete="family-name" />  <label class="form-sub-label" for="last_6" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_25"><div class="form-label-left" id="label_25"><label for="input_25"> Child's Hebrew Name<span class="form-required">*</span> </label><label class="label-message" for="input_25"> </label></div><div id="cid_25" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_25" name="q25_input25" size="20" value="" /> </div></li><li class="form-line" id="id_10"><div class="form-label-left" id="label_10"><label for="input_10"> Grade Entering as of 9/25<span class="form-required">*</span> </label><label class="label-message" for="input_10"> </label></div><div id="cid_10" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_10" name="q10_input10" size="20" value="" /> </div></li><li class="form-line" id="id_42"><div class="form-label-left" id="label_42"><label for="input_42"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_42"> </label></div><div id="cid_42" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q42_birthDate42[month]" id="input_42_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_42_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q42_birthDate42[day]" id="input_42_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_42_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q42_birthDate42[year]" id="input_42_year"><option></option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_42_year" id="sublabel_year">Year</label></span></div> </div></li><li id="cid_30" class="form-input-wide"> <div class="form-header-group"><h2 id="header_30" class="form-header">Emergency Information</h2><div id="subHeader_30" class="form-subHeader">(new addition to all registrations)</div></div> </li><li class="form-line" id="id_31"><div class="form-label-left" id="label_31"><label for="input_31"> Emergency Contact 1<span class="form-required">*</span> </label><label class="label-message" for="input_31"> </label></div><div id="cid_31" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q31_fullName31[first]" id="first_31" autocomplete="given-name" />  <label class="form-sub-label" for="first_31" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q31_fullName31[last]" id="last_31" autocomplete="family-name" />  <label class="form-sub-label" for="last_31" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_32"><div class="form-label-left" id="label_32"><label for="input_32"> Contact 1 Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_32"> </label></div><div id="cid_32" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q32_phoneNumber[area]" id="input_32_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_32_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q32_phoneNumber[phone]" id="input_32_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_32_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_33"><div class="form-label-left" id="label_33"><label for="input_33"> Emergency Contact 2 </label><label class="label-message" for="input_33"> </label></div><div id="cid_33" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q33_fullName33[first]" id="first_33" autocomplete="given-name" />  <label class="form-sub-label" for="first_33" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="15" name="q33_fullName33[last]" id="last_33" autocomplete="family-name" />  <label class="form-sub-label" for="last_33" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_34"><div class="form-label-left" id="label_34"><label for="input_34"> Contact 2 Phone Number </label><label class="label-message" for="input_34"> </label></div><div id="cid_34" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q34_phoneNumber34[area]" id="input_34_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_34_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q34_phoneNumber34[phone]" id="input_34_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_34_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_37"><div class="form-label-left" id="label_37"><label for="input_37"> 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. </label><label class="label-message" for="input_37"> </label></div><div id="cid_37" class="form-input"> <textarea id="input_37" class="form-textarea" name="q37_input37" cols="40" rows="4"></textarea> </div></li><li id="cid_35" class="form-input-wide"> <div class="form-header-group"><h2 id="header_35" class="form-header"></h2><div id="subHeader_35" class="form-subHeader">As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of the 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, the 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 the Chabad Hebrew School activities and that these pictures may be used for marketing purposes.</div></div> </li><li class="form-line" id="id_36"><div class="form-label-left" id="label_36"><label for="input_36"> I agree to the above:<span class="form-required">*</span> </label><label class="label-message" for="input_36"> </label></div><div id="cid_36" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q36_fullName36[first]" id="first_36" autocomplete="given-name" />  <label class="form-sub-label" for="first_36" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q36_fullName36[last]" id="last_36" autocomplete="family-name" />  <label class="form-sub-label" for="last_36" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_11"><div id="cid_11" class="form-input-wide"> <div id="text_11" class="form-html"><p style="text-align: center;"><b><font color="#ff0000" size="4"><u>PRICING FOR 2025/2026</u></font></b></p>

<p style="text-align: center;"><strong>Information and Payment</strong></p>

<p style="text-align: center;"><font color="#ff0000"><u><strong>Members: </strong></u> $850/ year</font></p>

<p style="text-align: center;"><font color="#ff0000"><u><strong>Non-Members: </strong></u> $1100/ year</font></p>

<p style="text-align: center;"><u><strong>Family Discount: </strong></u> 10% off each additional child</p>

<p style="text-align: center;"><u><strong>Tuition Paid in Full $30 Discount per child </strong></u></p>

<p style="text-align: center;">Registration fee $100 per child</p>


</div> </div></li><li class="form-line" id="id_38"><div class="form-label-left" id="label_38"><label for="input_38"> Registration Fee<span class="form-required">*</span> </label><label class="label-message" for="input_38"> $100/Child</label></div><div id="cid_38" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_38_0" name="q38_input38" value="$100 - One Child" /><label id="label_input_38_0" for="input_38_0"><span>$100 - One Child</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_38_1" name="q38_input38" value="$200 - Two Children" /><label id="label_input_38_1" for="input_38_1"><span>$200 - Two Children</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_38_2" name="q38_input38" value="$300 - Three Children" /><label id="label_input_38_2" for="input_38_2"><span>$300 - Three Children</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_39"><div class="form-label-left" id="label_39"><label for="input_39"> Please select:<span class="form-required">*</span> </label><label class="label-message" for="input_39"> </label></div><div id="cid_39" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_0" name="q39_input39" value="Member: 1 child: payment in full $820" /><label id="label_input_39_0" for="input_39_0"><span>Member: 1 child: payment in full $820</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_1" name="q39_input39" value="Member: 1 child: 4 payments $205*" /><label id="label_input_39_1" for="input_39_1"><span>Member: 1 child: 4 payments $205*</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_2" name="q39_input39" value="Member: 2 children: payment in full $1558 (with 10% discount on second registration)" /><label id="label_input_39_2" for="input_39_2"><span>Member: 2 children: payment in full $1558 (with 10% discount on second registration)</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_3" name="q39_input39" value="Member: 2 children: 4 payments $389.50*" /><label id="label_input_39_3" for="input_39_3"><span>Member: 2 children: 4 payments $389.50*</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_4" name="q39_input39" value="Member: 3 children: payment in full $2296 (with 10% discount on second and third registration)" /><label id="label_input_39_4" for="input_39_4"><span>Member: 3 children: payment in full $2296 (with 10% discount on second and third registration)</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_5" name="q39_input39" value="Member: 3 children: 4 payments $574*" /><label id="label_input_39_5" for="input_39_5"><span>Member: 3 children: 4 payments $574*</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_6" name="q39_input39" value="Non Member pricing: 1 child: payment in full $1070" /><label id="label_input_39_6" for="input_39_6"><span>Non Member pricing: 1 child: payment in full $1070</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_7" name="q39_input39" value="Non Member pricing: 1 child: 4 payments $267.50*" /><label id="label_input_39_7" for="input_39_7"><span>Non Member pricing: 1 child: 4 payments $267.50*</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_8" name="q39_input39" value="Non Member pricing: 2 children: payment in full $2033 (with 10% discount on second registration)" /><label id="label_input_39_8" for="input_39_8"><span>Non Member pricing: 2 children: payment in full $2033 (with 10% discount on second registration)</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_9" name="q39_input39" value="Non Member pricing: 2 children: 4 payments $508.25*" /><label id="label_input_39_9" for="input_39_9"><span>Non Member pricing: 2 children: 4 payments $508.25*</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_10" name="q39_input39" value="Non Member pricing: 3 children: payment in full $2996 (with 10% discount on second and third registration)" /><label id="label_input_39_10" for="input_39_10"><span>Non Member pricing: 3 children: payment in full $2996 (with 10% discount on second and third registration)</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_39_11" name="q39_input39" value="Non Member pricing: 3 children: 4 payments $749*" /><label id="label_input_39_11" for="input_39_11"><span>Non Member pricing: 3 children: 4 payments $749*</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line always-hidden" id="id_12"><div class="form-label-left" id="label_12"><label for="input_12"> Member Pricing </label><label class="label-message" for="input_12"> </label></div><div id="cid_12" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_12_0" name="q12_input12[]" value="1 Child, full upfront: $820 (with discount)" /><label id="label_input_12_0" for="input_12_0"><span>1 Child, full upfront: $820 (with discount)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_12_1" name="q12_input12[]" value="1 child: 4 payments $205" /><label id="label_input_12_1" for="input_12_1"><span>1 child: 4 payments $205</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_12_2" name="q12_input12[]" value="2 Children, full upfront: $1585 (with discount)" /><label id="label_input_12_2" for="input_12_2"><span>2 Children, full upfront: $1585 (with discount)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_12_3" name="q12_input12[]" value="2 children: 4 payments $389.50" /><label id="label_input_12_3" for="input_12_3"><span>2 children: 4 payments $389.50</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_12_4" name="q12_input12[]" value="3 children: payment in full $2296 (with 10% discount on second and third registration)" /><label id="label_input_12_4" for="input_12_4"><span>3 children: payment in full $2296 (with 10% discount on second and third registration)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_12_5" name="q12_input12[]" value="3 children: 4 payments $574" /><label id="label_input_12_5" for="input_12_5"><span>3 children: 4 payments $574</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line always-hidden" id="id_28"><div class="form-label-left" id="label_28"><label for="input_28"> Non-Member Pricing </label><label class="label-message" for="input_28"> </label></div><div id="cid_28" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_28_0" name="q28_input28[]" value="1 Child, full upfront: $1070 (with discount)" /><label id="label_input_28_0" for="input_28_0"><span>1 Child, full upfront: $1070 (with discount)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_28_1" name="q28_input28[]" value="1 child: 4 payments $267.50" /><label id="label_input_28_1" for="input_28_1"><span>1 child: 4 payments $267.50</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_28_2" name="q28_input28[]" value="2 children: payment in full $2033 (with discount)" /><label id="label_input_28_2" for="input_28_2"><span>2 children: payment in full $2033 (with discount)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_28_3" name="q28_input28[]" value="2 children: 4 payments $508.25" /><label id="label_input_28_3" for="input_28_3"><span>2 children: 4 payments $508.25</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_28_4" name="q28_input28[]" value="3 children: payment in full $2996 (with discount)" /><label id="label_input_28_4" for="input_28_4"><span>3 children: payment in full $2996 (with discount)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_28_5" name="q28_input28[]" value="3 children: 4 payments $749" /><label id="label_input_28_5" for="input_28_5"><span>3 children: 4 payments $749</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_13"><div class="form-label-left" id="label_13"><label for="input_13"> Total </label></div><div id="cid_13" class="form-input"> <div id="total_amount">$0.00 </div><div class="form-single-column form-checkbox-item" id="div_offset_gift_13" style="padding-top: 10px">		<input type="checkbox" id="input_13" class="form-checkbox" name="q13_offsetGiftPercent" value="3" />		<label id="label_13" for="input_13">Yes, I'd like to donate the cost of processing this transaction by adding 3%</label>		<input type="hidden" id="hidden_13" name="q13_offsetGiftAmount" />		<div class="clearfix"></div>		</div> </div></li><li class="form-line" id="id_14"><div class="form-label-left" id="label_14"><label for="input_14"> Payment </label><label class="label-message" for="input_14"> </label></div><div id="cid_14" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2" class="form-payment-methods form-multiple-column"></td></tr><tr class="credit_card "><th colspan="2">Credit Card</th></tr><tr class="credit_card "><td colspan="2" style="padding:0"><table cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container">  <label class="form-sub-label">We accept Visa, MasterCard, American Express, Discover</label></span><div class="cc-icons"><div class="cc-icon visa-icon"></div><div class="cc-icon mastercard-icon"></div><div class="cc-icon amex-icon"></div><div class="cc-icon discover-icon"></div></div><input type="hidden" name="q14_payment[cc_type]" id="input_14_cc_type" value="" /></td></tr><tr><td><div class="cc-field-wrapper"><span class="form-sub-label-container"><input class="form-textbox form-creditcard js-cc-number validate[visible, creditcard]" type="text" name="q14_payment[cc_number]" id="input_14_cc_number" autocomplete="cc-number" size="20" />  <label class="form-sub-label" for="input_14_cc_number" id="sublabel_cc_number">Credit Card Number</label></span></div></td><td class="cc_ccv "><span class="form-sub-label-container"><input class="form-textbox validate[visible]" type="text" name="q14_payment[cc_ccv]" id="input_14_cc_ccv" autocomplete="cc-csc" size="6" />  <label class="form-sub-label" for="input_14_cc_ccv" id="sublabel_cc_ccv">Security Code</label></span></td></tr><tr><td colspan="2" class="cc_name_on_card "><span class="form-sub-label-container"><input class="form-textbox validate[visible]" type="text" name="q14_payment[cc_nameOnCard]" id="input_14_cc_nameOnCard" autocomplete="cc-name" size="33" />  <label class="form-sub-label" for="input_14_cc_nameOnCard" id="sublabel_cc_nameOnCard">Name on Card</label></span></td></tr><tr class="credit_card "><td colspan=""><span class="form-sub-label-container"><select class="form-textbox validate[visible]" name="q14_payment[cc_exp_month]" id="input_14_cc_exp_month" autocomplete="cc-exp-month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_14_cc_exp_month" id="sublabel_cc_exp_month">Expiration Month</label></span></td><td><span class="form-sub-label-container"><select class="form-textbox validate[visible]" name="q14_payment[cc_exp_year]" id="input_14_cc_exp_year" autocomplete="cc-exp-year"><option></option><option value="2025">2025</option><option value="2026">2026</option><option value="2027">2027</option><option value="2028">2028</option><option value="2029">2029</option><option value="2030">2030</option><option value="2031">2031</option><option value="2032">2032</option><option value="2033">2033</option><option value="2034">2034</option></select>  <label class="form-sub-label" for="input_14_cc_exp_year" id="sublabel_cc_exp_year">Expiration Year</label></span></td></tr></tbody></table></td></tr><tr class="billing_address "><th colspan="2">Billing Address</th></tr><tr class="billing_address "><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q14_payment[addr_line1]" id="input_14_addr_line1" autocomplete="billing address-line1" />  <label class="form-sub-label" for="input_14_addr_line1" id="sublabel_14_addr_line1">Street Address</label></span></td></tr><tr class="billing_address "><td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-city" type="text" name="q14_payment[city]" id="input_14_city" autocomplete="billing address-level2" />  <label class="form-sub-label" for="input_14_city" id="sublabel_14_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox form-address-state" type="text" name="q14_payment[state]" id="input_14_state" autocomplete="billing address-level1" />  <label class="form-sub-label" for="input_14_state" id="sublabel_14_state">State / Province</label></span></td></tr><tr class="billing_address "><td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-postal" type="text" name="q14_payment[postal]" id="input_14_postal" size="10" autocomplete="billing postal-code" />  <label class="form-sub-label" for="input_14_postal" id="sublabel_14_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown form-address-country" name="q14_payment[country]" id="input_14_country" autocomplete="billing country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_14_country" id="sublabel_14_country">Country</label></span></td></tr></tbody></table> </div></li><li class="form-line" id="id_27"><div class="form-label-left" id="label_27"><label for="input_27"> Questions/Comments: </label><label class="label-message" for="input_27"> </label></div><div id="cid_27" class="form-input"> <textarea id="input_27" class="form-textarea" name="q27_input27" cols="40" rows="6"></textarea> </div></li><li class="form-line" id="id_18"><div id="cid_18" class="form-input-wide"> <div id="text_18" class="form-html"><p>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. If for any reason you decide to cancel during the year, you will be refunded/ not charged from the beginning of the next month. There are no refunds after May 1st. I understand that by receiving the early bird discount my first payment is non-refundable.</p></div> </div></li><li class="form-line" id="id_19"><div class="form-label-left" id="label_19"><label for="input_19"> Name<span class="form-required">*</span> </label><label class="label-message" for="input_19"> </label></div><div id="cid_19" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_19" name="q19_input19" size="20" value="" /> </div></li><li class="form-line" id="id_20"><div class="form-label-left" id="label_20"><label for="input_20"> Date<span class="form-required">*</span> </label><label class="label-message" for="input_20"> </label></div><div id="cid_20" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_20" name="q20_input20" size="20" value="" /> </div></li><li class="form-line always-hidden" id="id_26"><div class="form-label-left" id="label_26"><label for="input_26"> FOR OFFICE USE ONLY </label><label class="label-message" for="input_26"> </label></div><div id="cid_26" class="form-input"> <div class="form-multiple-column"><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_26_0" name="q26_input26[]" value="CMS" /><label id="label_input_26_0" for="input_26_0"><span>CMS</span></label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_26_1" name="q26_input26[]" value="Communicator" /><label id="label_input_26_1" for="input_26_1"><span>Communicator</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_26_2" name="q26_input26[]" value="Attendance Roster" /><label id="label_input_26_2" for="input_26_2"><span>Attendance Roster</span></label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_26_3" name="q26_input26[]" value="Sign-In Sheet" /><label id="label_input_26_3" for="input_26_3"><span>Sign-In Sheet</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_26_4" name="q26_input26[]" value="School Roster (On Drive)" /><label id="label_input_26_4" for="input_26_4"><span>School Roster (On Drive)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_26_5" name="q26_input26[]" value="Billing" /><label id="label_input_26_5" for="input_26_5"><span>Billing</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_45"><div class="form-label-left form-label-hidden" id="label_45"></div><div id="cid_45" class="form-input"> <div class="form-single-column form-checkbox-item"><input name="optin" value="true" type="checkbox" checked="checked" class="form-checkbox" id="input_45" /><label id="label_input_45" for="input_45">I would like to receive news and updates by email</label></div> </div></li><li class="form-line" id="id_2"><div id="cid_2" class="form-input-wide"> <div style="text-align: center;" class="form-buttons-wrapper button-align-center"><button id="input_2" type="submit" class="form-submit-button  form-submit-button-none;">Submit</button></div> </div></li><li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li></ul></div><input type="hidden" id="simple_spc" name="simple_spc" value="3739070" /><script type="text/javascript">document.getElementById("si"+"mple"+"_spc").value = "3739070-3739070";</script><div>


<script>
	var recaptchaIsEnterprise = false;
		 var recaptchaV2Key = "6LcG_TcUAAAAAKAVgwgW39ujc9OCjXSoQYFIA-Su";

</script>

	<input type="hidden" class="js-recaptcha-input" name="cdo-captcha-response" value="" data-div-id="3191e794-596e-4f44-9e72-b10460805268" data-processed="false" />
	<div class="js-recaptcha-wrapper" id="3191e794-596e-4f44-9e72-b10460805268"></div>	
</div></form></div>
<div class="center small">
	<img valign="absbottom" src="https://w2.chabad.org/images/global/icons/lock.gif" width="16" height="16" alt="Secure"> This page uses TLS encryption to keep your data secure.
</div>
	<div class="break_floats"></div>
	

<div class="content-footer">
	
	
	
	
		<div class="section-articles below-article clearfix" id="MoreInSection" data-list-name="more in this section">
			<h2 class="below-article__title">More in this section</h2>
			<div class="bs-container">
				<div class="bs-row">
					
		<div class="section-articles__column col-md-6 ">
			<ul class="small-links small-links--orange">
				
		<li class="small-links__item ">
			
			<a class="link_item" href="/templates/articlecco_cdo/aid/3739089/jewish/5786-New-Student-Registration.htm" data-aid="3739089">5786 New Student Registration</a>
		</li>
		
	
			</ul>
		</div>
	
				</div>
			</div> 
		</div>
	
		

	
	
</div>
	</article>

		</div>
	</div>
</div>
						
						<div class="break_floats"></div>
						
					</div>
				</div>
				
				
				
			</div>
			
			<!-- BEGIN FOOTER --></div></div>

</div>
</div>
<div id="border_bottom"></div>
</div>

<!-- END FOOTER -->
		</div>
		
		<aside class="page-tools-sidebar js-page-tools-sidebar hide_for_print">
<div class="page-tools js-page-tools-menu">
<div class="page-tools__section page-tools__section--share">
<a class="page-tools__tool js-share-popup page-tools__tool--facebook" data-share-url="https://www.facebook.com/dialog/share?app_id=188669250943&amp;display=popup&amp;href=https%3a%2f%2fwww.chabadirvine.org%2ftemplates%2farticlecco_cdo%2faid%2f3739070%2fjewish%2f5786-Returning-Student-Registration.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dFB">
				<i class="fa fa-facebook"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--twitter" data-share-url="https://twitter.com/intent/tweet?text=5786+Returning+Student+Registration+-+Chabad+of+Irvine&amp;url=https%3a%2f%2fwww.chabadirvine.org%2ftemplates%2farticlecco_cdo%2faid%2f3739070%2fjewish%2f5786-Returning-Student-Registration.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dtwitter&amp;via=Chabad">
				<i class="fa fa-twitter"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--whatsapp d-lg-none js-share-whatsapp" data-share-url="whatsapp://send?text=5786+Returning+Student+Registration+-+Chabad+of+Irvine https%3a%2f%2fwww.chabadirvine.org%2ftemplates%2farticlecco_cdo%2faid%2f3739070%2fjewish%2f5786-Returning-Student-Registration.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dwhatsapp">
				<i class="fa fa-whatsapp">
					<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 50 50" fill="#128c7e" width="1em" height="1em"><path d="M25 2C12.318 2 2 12.318 2 25c0 3.96 1.023 7.854 2.963 11.29L2.037 46.73c-.096.343-.003.711.245.966.191.197.451.304.718.304.08 0 .161-.01.24-.029l10.896-2.699C17.463 47.058 21.21 48 25 48c12.682 0 23-10.318 23-23S37.682 2 25 2zm11.57 31.116c-.492 1.362-2.852 2.605-3.986 2.772-1.018.149-2.306.213-3.72-.231-.857-.27-1.957-.628-3.366-1.229-5.923-2.526-9.791-8.415-10.087-8.804-.295-.389-2.411-3.161-2.411-6.03s1.525-4.28 2.067-4.864c.542-.584 1.181-.73 1.575-.73s.787.005 1.132.021c.363.018.85-.137 1.329 1.001.492 1.168 1.673 4.037 1.819 4.33.148.292.246.633.05 1.022s-.294.632-.59.973-.62.76-.886 1.022c-.296.291-.603.606-.259 1.19s1.529 2.493 3.285 4.039c2.255 1.986 4.158 2.602 4.748 2.894.59.292.935.243 1.279-.146.344-.39 1.476-1.703 1.869-2.286s.787-.487 1.329-.292c.542.194 3.445 1.604 4.035 1.896.59.292.984.438 1.132.681.148.242.148 1.41-.344 2.771z"/></svg>
				</i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--pinterest d-none d-lg-block" data-share-url="http://pinterest.com/pin/create/button/?url=https%3a%2f%2fwww.chabadirvine.org%2ftemplates%2farticlecco_cdo%2faid%2f3739070%2fjewish%2f5786-Returning-Student-Registration.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dpinterest&amp;description=5786+Returning+Student+Registration+-+Chabad+of+Irvine">
				<i class="fa fa-pinterest"></i>
			</a>
<a class="page-tools__tool" onclick="showEmailLayer(this);">
<i class="fa fa-envelope"></i>
</a>
</div>
<div class="page-tools__section page-tools__section--other js-page-tool-other">
<div class="page-tools__tool popover-parent d-lg-block">
<div class="popover popover--right align_left nowrap">
<div class="popover__content">
<label class="bold bottom_margin block">
Print Options:
</label>
<form class="vcenter" name="print-form" onsubmit="coPrint(event, 5534637);return false;">
<div>
<label><input type="checkbox" name="print-green"><span title="Save paper and ink">Print without images <i class="fa fa-leaf text-green"></i></span></label>
</div>
<br/>
<div class="center">
<button class="co-button page-tools__print-button">Print</button>
</div>
</form>
</div>
</div>
<i class="fa fa-print"></i>
</div>
</div>
</div>
<div class="js-fab-wrapper fab-wrapper">
<div class="fab">
<i class="fab-icon"></i>
</div>
</div>
</aside>
<!-- END CACHE -->
	</div>

				<div class="break_floats"></div>
			</div>
		</div>
	</div>
	<div id="footer">
		
	

		<div class="wrapper body_container">
			
				<div class="g960 footer_family_text bottom_padding">
					
		<div class="footer_container footer_text copyright_text">
			<div class="bottom_padding clear_float">
				<img class="footer_hr" src="https://w2.chabad.org/images/global/spacer.gif" vspace="12" width="100%" height="1" /><br />
				
				<div class="footer_inner_container clearfix">
					

					



	<div class="footer3">
		<span class="footer-title" >Chabad of Irvine</span>
		<div class="footer-address">
			<span class="footer-street">5010 Barranca Parkway </span>
			<span class="footer-city-state">Irvine, CA 92604</span>
		</div>
			<span>949-786-5000</span>
	</div>
	<img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="6" border="0" /><br />



Powered by <a href="https://www.chabad.org/" target="_new" class="">Chabad.org</a> &copy; 1993-2026 <a href="/4026210" target="_blank" class="privacy-link">Privacy Policy</a>




					
				</div>
			</div>
		</div>
	


<div class="cs-f-social-icons">
	
			<a href="https://www.facebook.com/ChabadIrvine" class="fa fa-facebook facebook_homepage" title="Facebook"></a>
		
</div>
	

				</div>
			
		</div>
	</div>

	
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery-latest.min.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery/jquery.inputmask.min.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/co/dist/CoLib.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/WebComponents/bundles/magen-cdo-global.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/sites6.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/primarynavigation.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/modules/pagetools.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/BetaFeedback.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/multimedia/infolayer.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/forms/userform.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/commentsloader.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/minisites.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/subscribeprompt.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/FormDecoder.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/deprecated.js?v=4.1.3"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/OverrideJSDocumentWrite.js"></script><script>$j = $j.fn ? $j : jQuery;$j(()=>{$q.forEach(f=>{try{f.call(window);}catch(ex){console.error(ex);}});})</script>
	

<script  language="javascript" type="text/javascript"> Co.Settings      = {CacheClassName:'js-cache-default',MosadName:'Chabad of Irvine'}; Co.ArticleId     = '3739070';Co.SectionId     = 4681105;Co.PartnerSiteId = 0;Co.SiteId        = 18;Co.IsMobilePage  = false;Co.IsResponsive  = false;Co.DbDomain      = 'ChabadIrvine.org';Co.LanguageCode  = '';Co.LoginStatus   = 'None';</script>

    

</body>
</html>