2023 Hebrew School Registration Form

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Hebrew School Registration Form 2022-2023
Which location are you registering to?*
Full Name*

First Name Last Name
How many children are you registering?*
Child 1 Information
Full Name*

First Name Last Name
Jewish Name
Birth Date*

Month Day Year
Jewish Birthday* Use our Jewish Birthday Calculator

https://www.chabad.org/calendar/birthday_cdo/aid/6228/jewish/Jewish-Birthday-Calculator.htm
Gender*

Male Female
School*
Grade Entering in September 2022*
Medical Information*

Please include allergies, curent medication & any learning disabilities or challenges. All information will be kept confidential
Child 2 Information
Full Name*

First Name Last Name
Jewish Name
Birth Date

Month Day Year
Jewish Birthday* Use our Jewish Birthday Calculator

https://www.chabad.org/calendar/birthday_cdo/aid/6228/jewish/Jewish-Birthday-Calculator.htm
Gender*

Male Female
School*
Grade Entering in September 2022*
Medical Information*

Please include allergies, curent medication & any learning disabilities or challenges. All information will be kept confidential
Child 3 Information
Full Name*

First Name Last Name
Jewish Name
Birth Date*

Month Day Year
Jewish Birthday* Use our Jewish Birthday Calculator

https://www.chabad.org/calendar/birthday_cdo/aid/6228/jewish/Jewish-Birthday-Calculator.htm
Gender*

Male Female
School*
Grade Entering in September 2022*
Medical Information*

Please include allergies, curent medication & any learning disabilities or challenges. All information will be kept confidential
Parent Information
Parent 1 Name*

First Name Last Name
Parent 2 Name

First Name Last Name
Marital Status*

Address*

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

Parent 1 E-mail*
Parent 1 Cell Number*

Area Code Phone Number
Parent 2 E-mail
Parent 2 Cell Number

Area Code Phone Number
Jewish Status of Birth Mother*

Born Jewish Converted Not Jewish
Jewish Status of Birth Father*

Born Jewish Converted Not Jewish
Emergency contact other than parents
Full Name*

First Name Last Name
Relationship to child?
Phone Number*

Area Code Phone Number
Payment
$100 registration fee per child is required. This amount will be deducted from the tuition.
Vancouver tuition is $550. The tuition includes all supplies & a weekly dinner.

10% sibling discount will automatically be applied to all registrations of two or more children from the same family

Scholarships are available based on need. After submitting your registration form, please email [email protected] to request a scholarship form
Langley tuition is $500. The tuition includes all supplies & a healthy snack

10% sibling discount will automatically be applied to all registrations of two or more children from the same family

Scholarships are available based on need. After submitting your registration form, please email [email protected] to request a scholarship form
Tri - Cities tuition is $500. The tuition includes all supplies & a healthy snack.

10% sibling discount will automatically be applied to all registrations of two or more children from the same family

Scholarships are available based on need. After submitting your registration form, please email [email protected] to request a scholarship form
Squamish & Whistler tuition is $770. The tuition includes all supplies & a healthy snack.

10% sibling discount will automatically be applied to all registrations of two or more children from the same family

Scholarships are available based on need. After submitting your registration form, please email [email protected] to request a scholarship form
Total

$0.00 CAD
Please Select*

Charge me the full tuition amount today I will Request a subsidy

Payment*

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please review our policies*

I hereby permit staff of BC Regional Hebrew School to provide routine health care and to obtain emergency medical care as the situation mandates. I allow staff of BC Regional Hebrew School to use photographs/video of my child for promotional purposes, including social networking sites. I agree to abide by all COVID-19 policies & regulations
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Hebrew School Registration Form 2022-2023

Parent Information

Emergency contact other than parents

Payment