Hebrew School registration

Parent 1

First Name *

Last Name *

Phone Number *

Email *

Street Address *

Street Address Line 2

City *

State/Province *

Postal Code *

Religious affiliation *

Other religious affiliation *

Parent 2

First Name *

Last Name *

Phone Number

Relationship to Parent 1 *

Share address of

Same Address as Parent 1

Street Address

Street Address Line 2

City

State/Province

Postal Code

Religious affiliation *

Other religious affiliation *

Child information

First Name *

Last Name *

Birth Date *

Month

Day

Year

Street Address (where child resides) *

Street Address Line 2

City *

State/Province *

Postal Code *

Registering For *

K-6 program | Village Hebrew 23-24 - September 13th, 2023

3s and 4s program | Village Hebrew 23-24 - September 13th, 2023

West Village Hebrew 24-25 - September 1st, 2024

Fall Semester Tuition $

Spring Semester Tuition $

Does your child have any allergies or other medical conditions we should be aware of? *

Yes

Please describe them and indicate special precautions or care needed. *

Emergency Contact

First Name *

Last Name *

Phone Number *

Relationship to Child *

Consent *

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 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.

Chabad West Village