2026-2027 CKids After School Registration Form - Chabad Lubavitch of British Columbia

CKids After School Registration Form 2026-2027
Your 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 2026*
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
Please Select Program*

Mondays and Tuesdays- After School- Grades 3-7Wednesday- Hebrew School- grades K-7Both Hebrew School & After School (Monday, Tuesday, Wednesday) Grades 3-7
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
Tuition cost:

After School (Grades 3-7) - $350/session*. Register for all three sessions and save $50! Total $999
Hebrew School (Grades K-7) - $999 for the full year (no session options)
COMBO! After School + Hebrew School (Gr. 3-7 only)- $1,499 for the full year (save $550!)

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.

*There are 3 sessions throughout the year - Fall, Winter and Spring
$100 non-refundable registration fee per child is required. This amount will be deducted from the tuition.
Registration Fee

$0.00 CAD
Please Select*

Charge me the full tuition amount todayDivide my tuition into 9 monthly paymentsI will apply for a scholarship

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.
Should be Empty:

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CKids After School Registration Form 2026-2027