Child Information
Child's Name Hebrew Name
Date of Birth School
 
Parent Information
Father's Name Email
Work Phone Cell Phone
Mother's Name Email
Work Phone Cell Phone
Address City
State Zip
 
Select Gan Israel ELC Duration

Please Select:
Full week Monday - Friday
4 days
3 days
2 days
1 day

 Before Care 8-9 AM
 After Care 3-4 PM
 After Care 4-5 PM

Non refundable registration fee $250.00

 
Payment Information
Card Number Billing Zip Code
Expiration CVV Code What's This?

Please note we will mail you forms to be completed before the school year.