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Hebrew School Registration

Hebrew School Registration

CHABAD HEBREW SCHOOL REGISTRATION FORM 
For more info please Email:     info@chabadofwestchester.com


  • Sunday Program from 9:30-12:00.......................$1100
  • Enrichment Wednesdays 3:45-5:15 (Sun. & Wed. class)....................$1725
  • Special-ed program Mondays 3:15-5:45 (w/o lang.).....................$1500

Early Bird Special:
Pay in full by July 5,  and receive the following special rates:
Sundays: $1025; Sundays and Wednesdays $1675. 

Student's Name:

Students' Hebrew Name:

Birth Date:

Grade Entering:

Address:

Home Telephone Number:

e-mail:

School Name and Town:

Father's Name:

Father's Cell Number:

Father's email address:

Mother's Name:

Mother's Cell Number:

Mother's email address: 

Names and ages of other children in family:

Have there been any conversions in the family? Please explain.

 

Is the child adopted?

ABOUT YOUR CHILD:

Does your child read basic Hebrew?

Previous Religious School Education:

Does your child have any learning difficulties with general studies? Please explain:

Is there anything you want us to know about your child that would help us to help him/her:

GENERAL:

Does either parent have any special resources or skills to offer our children or teachers?

We grant permission for our children to be photographed in an individual or group picture which may be used by the school for PR purposes (names of children are never released). Agree or Disagree:

Please list all names of people who are authorized to take child to and from school:

MEDICAL EMERGENCY INFORMATION:

In case of emergency, when neither parent can be reached, provide names of TWO people who will take responsibility for your child:

If parents cannot be reached and emergency medical advice is needed, permission is given to the Hebrew School staff to phone my child's doctor.  Agree or Disagree:

Doctor's Name:

Doctor's Address:

Doctor's Phone:

Doctor's Hospital Affiliation:

In case of medical emergency requiring immediate emergency care, I authorize to take my child to the hospital, if necessary. Agree or Disagree:

FURTHER MEDICAL INFORMATION:

Allergic reactions to medication:

Medication child is taking on a regular basis:

Any special medical circumstances or allergies:

PAYMENT INFORMATION:
Credit card
Name on card: 

Street address: 

City, State, Zip:

Phone Number:

Amount to charge: 

Card Type (Visa, Mastercard, Amex): 

Name on Card: 

Credit card number: 

Expiration Date: 

Security code:  

 Chabad of Westchester

mailing address:  One Chase Road Scarsdale new York 10583 

CHABAD HEBREW SCHOOL TUITION CONTRACT.  PLEASE FILL OUT A FORM FOR EACH CHILD BEING ENROLLED IN THE SCHOOL.

(I/we) enroll our child for the 2013-2014 school year, subject to the terms of this contract.

ALL TUITIONS ARE NON-REFUNDABLE

ADDITIONAL TERMS AND CONDITIONS:

  1. (I/We) agree that (my/our) child will not be allowed to attend classes unless tuition is kept current.
  2. Every child is enrolled for the entire school year.  The school cannot issue refunds or credits for illness, holidays, family vacations or early withdrawal.
  3. In the event that the school is closed due to or resulting from any emergency or weather situation, there will be no make up days or refunds for days that the school is not in session.
  4. The school reserves the right to terminate this agreement if it determines in its sole judgement:
    • that the child's behavior hinders or prevents the school staff from safely supervising the child, or
    • the child is detrimental to himself/herself or to others.
    • If such action is taken by the school, no refund will be made.
  5. Chabad reserves the right to use the name and photographs or any form of recording of the child for its brochure and promotional materials.

I HAVE READ, UNDERSTOOD, AND AGREED TO ALL CHARGES, TERMS, AND CONDITIONS SET FORTH IN THIS CONTRACT.  I also agree to allow my child to participate in all school activities on or off school grounds.

Parent Name and Date:

  

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