Registration - Chabad of Chula Vista

CHILD 1 INFORMATION

Full Name*

First NameLast NameHebrew NameAge

Birth Date*

MonthDayYear

Gender*

MaleFemale

Current Grade*

Previous Jewish Education

Hebrew Reading Proficiency

Does your child have any allergies?*

CHILD 2 INFORMATION

Full Name

First NameLast NameHebrew NameAge

Birth Date

MonthDayYear

Gender

MaleFemale

Current Grade

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

Father's Name*

First NameLast Name

Father Cell*

Area CodePhone Number

Father's E-mail*

Mother's Name*

First NameLast Name

Mother Cell*

Area CodePhone Number

Mother's E-mail*

FAMILY INFORMATION

Is the biological mother of the child Jewish?*

YesNo

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

YesNo

If yes, who was the Rabbi?

EMERGENCY INFORMATION & TERMS

Emergency Contact*

First NameLast NameRelationship

Phone Number*

Area CodePhone 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

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: $275 for 15 classes | Jan 19 - May 31 | Sunday's 10am-12pm
Sibling Discount: 10% discount for the second child.

* Synagogue membership is NOT required. Please note, that no child will be turned away due to lack of funds. Please contact us to discuss any financial considerations.

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.