2024-2025 Hebrew School Registration Form

Hebrew School Registration Form 2024-2025
Full Name*
First Name Last Name
Child Information
Full Name*
First Name Last Name
Preferred 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*

MaleFemale
School*
Grade Entering in September 2024*
Please upload a picture of your child*
Medical Information*
Please describe this child's information. For example: allergies, medical diagnosis or other special needs
Currently taking any medications?*

YesNo
Please describe
Is the child up to date with immunizations?*

YesNo
Does the child have any dietary restrictions

Gluten freeVegetarianVegan
Does the child have an IEP at school? If so, please upload a copy
Please describe this child's learning difficulties and how we can best support his/her learning needs
Parent Information
Parent 1 Name*
First Name Last Name
Parent 2 Name
First Name Last Name
Marital Status*

Address*

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 JewishConvertedNot Jewish
Jewish Status of Birth Father*

Born JewishConvertedNot Jewish
Emergency contact other than parents
Full Name*
First Name Last Name
Relationship to child?
Phone Number*

Area Code Phone Number
Payment
$100 non-refundable registration fee per child is required. This amount will be deducted from the tuition.
Tuition cost - $999 if registered and paid by August 15, 2024. After August 15 the price is $1,099 per child. All tuition fees are fully tax-deductable

No child will be turned away due to lack of funds. Please contact our office if you need financial assistance.
Total

$0.00 CAD
Please Select*

Charge me the full tuition amount todayDivide my tuition into 9 monthly payments

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 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.
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Hebrew School Registration Form 2024-2025