HEBREW SCHOOL REGISTRATION FORM

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SCHOOL YEAR 2023/2024

Email *

Child Name *

Birth Date *

YYYY

Hebrew Name

School Attending *

Previous Jewish Education

Grade Entering *

Home Address *

Any allergies? *

Yes

If yes, to what?

PARENTS INFORMATION

Parent Name *

Parent Cell Number *

Mother's Hebrew Name

Mother Jewish By *

Birth

Choice

Other:

Any conversion on the mother's side of the family? *

Yes

Best way to send Hebrew School updates *

Text

Handouts in school

I give permission for photographs and / or video of my child be taken, and I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes. This might include (but is not limited to), the right to use them in printed and online publicity, social media, press releases and funding applications. *

Yes

Required

I hereby permit my child to participate in all school activities and join in school trips on and beyond school properties. In case of emergency, I hereby authorize the school to have my child taken care of by a physician in any way the situation may call for. *

Yes

Required

Tuition Options: (Check or Credit Card) *

I will pay tuition in full ($500)

I will pay tuition in 2 installments of $250 each

Credit Card Number (If paying by Credit Card)

Expiration Date

Security Code

Send me a copy of my responses.

Submit

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