Returning Student Registration

Hebrew School Registration - Payment Plans
Plan A: Pay full tuition upfront ($30 discount).
Plan B: Pay in 4 or 8 installments by check or automatically charged credit card (a 3% processing fee will be added to your payment.)
If this coming year will be the first time your child is joining us for Hebrew School please fill out our new student form here .
Parent's Full Name*
First NameLast Name
Child 1 Full Name*
First NameLast Name
Child's Hebrew Name*
Grade Entering as of 9/21*
Child 2 Full Name
First NameLast Name
Child's Hebrew Name
Grade Entering as of 9/21
Child 3 Full Name
First NameLast Name
Child's Hebrew Name
Grade Entering as of 9/21
Emergency Information
(new addition to all registrations)
Emergency Contact 1*
First NameLast Name
Contact 1 Phone Number*
Area CodePhone Number
Emergency Contact 2
First NameLast Name
Contact 2 Phone Number
Area CodePhone Number
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.
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.
I agree to the above:*
First NameLast Name
DISCOUNTED PRICING FOR 2021/22
Information and Payment
Members:  $850/ year
Non-Members:  $1100/ year
Family Discount:  10% off each additional child
$50 Early Bird Discount if you sign up by July 6, 2021
Registration fee $75 per child
Registration
$75
Member Pricing
1 Child, full upfront: $820 (with discount)1 Child, 4 payments: $212.501 Child, 8 Payments: $106.252 Children, full upfront: $1585 (with discount)2 Children, 4 payments: $403.752 Children, 8 payments: $201.87
Non-Member Pricing
1 Child, full upfront: $1070 (with discount)1 Child, 4 payments: $2751 Child, 8 payments: $137.502 Children, full upfront: $2060 (with discount)2 Children, 4 payments: $522.502 Children, 8 payments: $261.25
Total
$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%
(3% charge will be applied to all credit card transactions)

Payment

Credit Card Check

Postal / Zip Code

Country

Questions/Comments:
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 recieving the early bird discount my first payment is non-refundable.
Name*
Date*
FOR OFFICE USE ONLY
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Emergency Information