Returning Students Registration - ChabadNorthHollywood.org

If you are a returning student, you can fill out the brief registration form below. New students register here.

Please note that we require one registration form per child.

We look forward to a wonderful year of learning and growth.

Tuesday Afternoons, 3:45- 6:00 PM
Tuition $950 + $50 registration fee

Registration Fee

$50

Full Name*

First Name Last Name

Hebrew Name*

DOB*

Month Day Year

School Attending*

Grade Entering*

Father's Name*

First Name Last Name

Mother's Name*

First Name Last Name

Phone Number*

Is the address we have on record correct?*

Address*

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

Father's E-mail*

Mother's E-mail*

Emergency Contact 1 Name*

First Name Last Name

Emergency Contact 1 Phone Number*

Emergency Contact 2 Name*

First Name Last Name

Emergency Contact 2 Phone Number*

AS THE PARENT(S) OR LEGAL GUARDIAN 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*

I accept

Full Name*

First Name Last Name

Initials *

Comments or Questions? Please Share Your Thoughts.

Registration fee:

$50.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Please charge my balance:*

In full to the card above.Please charge the card above seven times, September through March.I will submit 7 checks, dated September through March. All checks must be submitted before the first day of Hebrew School.