Hebrew School Registration

Address*

Additional Notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Does your child have any special accomodations/help in his/her regular school? Please elaborate
Parents Information
Father's Name*

First Name Last Name
Father's Cell*

Area Code Phone Number
Father's Email Address*
Mother's Name*

First Name Last Name
Mother's Hebrew Name
Mother Jewish by:*

BirthChoice
Mother's Cell*

Area Code Phone Number
Mother's Email Address*
I am willing to assist in school activities, please contact me
Emergency Information
Emergency Contact 1*
Phone*
Emergency Contact 2*
Phone*
Permissions
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School of the Arts 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.
*

I Accept
Parent/Guardian Name*

First Name Last Name
Should be Empty:

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