We are currently accepting applications for the 2021-2022 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss, feel free to call our director Nechoma Goldman at 405-413-6091 or email [email protected].

Please note that one registration form per child is needed.

Hebrew School is for ages Prek3 and up.

Student Profile
 
Last Name
First Name
Hebrew Name
Age
DOB
School
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No
Where?

 

Parent Information
 
Address
City/Zip
Phone
Father's Name
Father's Occupation
Father's Cell
Email
Mother's Name
Mother's Occupation
Mother's Cell

 

Emergency Information
 
Emergency Contact 1
Phone
Emergency Contact 2
Phone
Doctor's Name
Doctor's Phone Number
Medical Insurance Company
Policy Number

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.

Registration Payment Agreement

Tuition for the year, per child:

$425 full year + $50 registration fee

* includes books

* scholarships available upon request 

Method of Registration payment:

Credit Card (form below)
Check (Please mail checks to Chabad Hebrew School )

 
Registration Payment
CC Type   Card Number
Billing Address   City, State, Zip
CVV   Exp Date

Total Registration charges:$

As the parent or legal guardian of the above child:


In the event of an emergency, I authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, and I further agree to pay all related charges. It is understood that if time and circumstances permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment.

 

I give permission for my child to participate in all school activities, and allow my child to be photographed while participating in Chabad Hebrew School activities, knowing that these pictures may be used for marketing purposes. 


I understand that I must carefully read and sign the COVID-19 Assumption of Risk, Release, and Waiver of Liability before my child may attend Chabad Hebrew School. (This will be provided to you upon registration.)


 

I Accept

Name: Initials: Date:

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