Returning Student

Registration: Returning Student

How many students are returning?

Child 1 Information

First Name

Last Name

Has any of this child’s information changed since last year?

What has changed?

Child 2 Information

First Name

Last Name

Has any of this child’s information changed since last year?

What has changed?

Child 3 Information

First Name

Last Name

Has any of this child’s information changed since last year?

What has changed?

Child 4 Information

First Name

Last Name

Has any of this child’s information changed since last year?

What has changed?

Parent Information

First Name

Last Name

Phone/Mobile

Emergency Contact

First Name

Last Name

Phone/Mobile

How do you want to pay?

Make 1 Single Payment

One time payment of $800.00

Pay in 10 Installments

$80.00 for each month, for 10 installments

How do you want to pay?

Make 1 Single Payment

One time payment of $1,600.00

Pay in 10 Installments

$160.00 for each month, for 10 installments

How do you want to pay?

Make 1 Single Payment

One time payment of $2,400.00

Pay in 10 Installments

$240.00 for each month, for 10 installments

How do you want to pay?

Make 1 Single Payment

One time payment of $3,200.00

Pay in 10 Installments

$320.00 for each month, for 10 installments

One Time Security Fee (per family)

Security Fee (per family): $80.00

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AS THE PARENT(S) OR LEGAL GUARDIAN OF THE ABOVE CHILD(REN), I/WE AUTHORIZE ANY ADULT ACTING ON BEHALF OF THE CHABAD HEBREW SCHOOL TO HOSPITALIZE OR SECURE TREATMENT FOR MY CHILD(REN), I/WE 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/WE HEREBY GIVE PERMISSION FOR MY CHILD(REN) TO PARTICIPATE IN ALL SCHOOL ACTIVITIES, JOIN IN CLASS AND SCHOOL TRIPS ON AND BEYOND SCHOOL PROPERTIES AND ALLOW MY CHILD(REN) TO BE PHOTOGRAPHED WHILE PARTICIPATING IN CHABAD HEBREW SCHOOL ACTIVITIES AND THAT THESE PICTURES MAY BE USED FOR MARKETING PURPOSES.