New Students Registration - JewishChulaVista.com

NEW STUDENTS REGISTRATION FORM
If you have any questions or concerns you would like to discuss with us, please feel free to call us at 619.836.0770 or email [email protected]

How many children would you like to register?*

CHILD 1 INFORMATION

Full Name*

First Name Last Name Hebrew Name Age

Birth Date*

Month Day Year

Time of Day: To calculate Jewish Birth date

Hour Minutes

Gender*

Male Female

Grade entering in September*

Preschool class is tentative. Class opening will be finalized once 3 or more students are registered.

Previous Jewish Education

Hebrew Reading Proficiency

Does your child have any allergies?*

CHILD 2 INFORMATION

Full Name*

First Name Last Name Hebrew Name Age

Birth Date*

Month Day Year

Time of Day: To calculate Jewish Birth date

Hour Minutes

Gender*

Male Female

Grade entering in September*

Preschool class is tentative. Class opening will be finalized once 3 or more students are registered.

Previous Jewish Education

Hebrew Reading Proficiency

Does your child have any allergies?

CHILD 3 INFORMATION

Full Name*

First Name Last Name Hebrew Name Age

Birth Date*

Month Day Year

Time of Day: To calculate Jewish Birth date

Hour Minutes

Gender*

Male Female

Grade entering in September*

Preschool class is tentative. Class opening will be finalized once 3 or more students are registered.

Previous Jewish Education

Hebrew Reading Proficiency

Does your child have any allergies?

ADDRESS

Address*

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

PARENT'S INFORMATION

Marital Status

Father's Name*

First Name Last Name

Father's Occupation*

Father Cell*

Area Code Phone Number

Father's E-mail*

Is the biological father of the child Jewish?*

Yes No

Mother's Name*

First Name Last Name

Mother's Occupation*

Mother Cell*

Area Code Phone Number

Mother's E-mail*

Is the biological mother of the child Jewish?*

Yes No

FAMILY INFORMATION

Have there been any conversions in your family?*

Yes No

If yes, who? And who was the Rabbi?*

Have there been adoptions in your family?*

Yes No

If yes, please explain?*

EMERGENCY INFORMATION & TERMS

Emergency Contact*

First Name Last Name Relationship

Phone Number*

Area Code Phone Number

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.

Additional notable information

How did you hear about Chabad Hebrew School

Terms of Agreement**

As the parent(s) or legal guardian(s) 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.

TUITION

Tuition: $995 per child (supplies, snacks & book fee included). | Sunday's 10am-12pm
Early-bird special: $895 for registration completed by July 15
Sibling Discount: 10% discount for the second child.

* Every Jewish child deserves a quality education. Please don't hesitate to reach out to us for a scholarship or payment plan that can work for your family. No child will be turned away due to lack of funds.

If you are in a position to contribute to our scholarship fund, please consider a $180-$995 or any amount donation.

ENROLLMENT

After you have successfully submitted your application it will be subject to review. We will reach out to schedule a follow up call to discuss your application and confirm it's approval. Once approved an invoice will be sent to complete your child's enrollment.

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