Register

Registration in now open!!

1) Please fill this form

2) We will contact you to setup a personal meeting

Please note: Your child is not registered in the Chabad Hebrew School until you receive a confirmation phone call or email.

Re-Register Dates & Rates

Child's Name*

First Name Last Name

Hebrew Name*

Birth Date*

Month Day Year

Previous Jewish Education* If YES where?

School 2024-2025*

Grade entering 2024-2025*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Additional notable Information

Father's Name*

First Name Last Name

Father Cell

Area Code Phone Number

Mother's Name*

First Name Last Name

Mother Cell

Area Code Phone Number

Is the natural mother of the child Jewish?*

YesNo

Have there been any conversions or adoptions in the family?*

YesNo

If yes, please explain

Emergency Contact Name

First Name Last Name

Phone Number

Area Code Phone Number

Relation

Is your child taking permanent medications?*

YesNo

Any known allergies (incl. reactions to medications) and any present medical conditions?*

YesNo

CONFIDENTIAL: Please list all allergies

Disclaimer

Accident: As the parent(s) or legal guardian of the above child/ren, I/we authorize any adult acting on behalf of Chabad of the Delta 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 of the Delta Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment.

Trips and Outings: I hereby give permission for my child to attend and participate in all trips and outings organized as part of the program by Chabad of the Delta Hebrew School.

Privacy: I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Chabad of the Delta website or for promotion of our program.

Digital Signature of Parent or Legal Guardian

Date

Month Day Year

Tuition

Hebrew School Primary Program: $700 (includes Book Fee)

Early-bird discount before August 5th: $600

Program & Tuition Agreement

I hereby confirm my child’s enrollment in Chabad of the Delta's Hebrew School.

I represent that I am the custodial parent or legal guardian of the child that I am enrolling and that the information

I have provided is true and correct.

I fully understand that this enrollment, as part of my commitment to a long-term Jewish education at Chabad of the Delta, is accepted only on the basis of the full year program, and agree to pay the full annual fees accordingly.

Digital Signature of Parent or Legal Guardian

Date

Month Day Year

Payment Plan

Payment #1 is due on or before August 1st, 2024 and payment # 2 is due on December 15th, 2024. Postdated check should be submitted. If paying by credit card, your card will be charged on December 15th, 2024.

Total

$0.00

Payment*

Credit Card Paypal Check

Postal / Zip Code

Country

Please note: Your child is not registered in the Chabad Hebrew School until you receive a confirmation phone call or email.

-Enrollment and acceptance in Chabad Hebrew School is in no way a validation of one’s status as a Jew-

Parents Information

Emergency Information

Disclaimer

Tuition and Billing

Payment