Parent's Information
Father's Information
First Name
Last Name
Phone
Email
Mother's Information
First Name
Last Name
Phone
Email
Home Address
Address
City
State
Zip
Student's Information
Student 1
First Name
Last Name
Hebrew Name (if known)
Birth Date
School
Grade Entering
Previous Jewish Education
Hebrew Reading Proficiency
Student 2
First Name
Last Name
Birth Date
School
Grade Entering
Previous Jewish Education
Hebrew Reading Proficiency
Jewish Status
Is the Natural Mother of the Child Jewish?
Tuition Payment Options
Permissions
I/we give permission for my child/ren to attend all field trips and outings that are part of the Chabad Hebrew School.
I/we grant permission for my child to have their photo/image and name published by Chabad.
As the parent(s) or legal guardian(s) of the above entered student, I/we authorize any adult acting on behalf of the Chabad Hebrew School to hospitalize or secure treatment for my child/ren. I further agree to pay for all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, The Chabad Hebrew School will try to communicate with me prior to such treatment.
Total Amount
0.00
Credit Card Information
Type
Visa
MC
Amex
Discover
Number
Expiration
/
Code
Use contact info above
Name
Address
Zip
Important Notice
The duties and obligations of Chabad Hebrew School under this agreement may be modified or suspended immediately and without notice because of force majeure events including, but not limited to, fire, flood, war, government action, terrorism, epidemic, pandemic, or any other event beyond CHS’s control. If such an event occurs, CHS’s duties and obligations may be modified, suspended, or postponed until such time as CHS, in its sole discretion, may safely resume operations. The sole financial remedy for a force majeure event is future service delivery and not a tuition refund. CHS may, at its option, amend the school year as needed in the event of an emergency that disrupts the normal academic calendar with circumstances beyond its control.
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