Register

Chabad Hebrew School 2024-25
Online Registration Form

We are now accepting registrations for the 2024-2025 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact Chanie Baitelman at [email protected]

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

Number of Students being registered:*

Full Name*

First Name Last Name

Hebrew Name (If child has one)

Birth Date*

Month Day Year

Gender*

MaleFemale

School Attending*

Grade Entering in September 2024*

Please upload a photo of your child*

Hebrew Reading Proficiency*

NoneSomewhatWell

Hebrew Speaking Proficiency*

NoneSomewhatWell

Previous Jewish Education/Hebrew School*

YesNo

If yes, please describe

Synagogue Affiliation*

Natural mother of child Jewish?*

YesNo

Natural father of child Jewish?*

YesNo

Is maternal grandmother Jewish?*

YesNo

Conversions / adoptions in family?*

YesNo

If yes, please describe

Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential):*

Medical Information: e.g. allergies, or other special needs*

Currently taking any medication?*

YesNo

Is this child up to date with immunization?*

YesNo

Full Name

First Name Last Name

Hebrew Name (If child has one)

Birth Date

Month Day Year

Gender

MaleFemale

School Attending

Grade Entering in September 2024

Please upload a photo of your child

Hebrew Reading Proficiency

NoneSomewhatWell

Hebrew Speaking Proficiency

NoneSomewhatWell

Previous Jewish Education/Hebrew School

YesNo

If yes, please describe

Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential):

Medical Information: e.g. allergies, or other special needs

Currently taking any medication?*

YesNo

Is this child up to date with immunization?*

YesNo

Full Name

First Name Last Name

Hebrew Name (If child has one)

DOB

Month Day Year

Gender

MaleFemale

School Attending

Grade Entering in September 2024

Please upload a photo of your child

Hebrew Reading Proficiency

NoneSomewhatWell

Hebrew Speaking Proficiency

NoneSomewhatWell

Previous Jewish Education/Hebrew School

YesNo

If yes, please describe

Synagogue Affiliation

Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential)

Medical Information: e.g. allergies, or other special needs

Currently taking any medication?*

YesNo

Is this child up to date with immunization?*

YesNo

Parent Information

Parent 1 Name*

First Name Last Name

Parent 1 Home Phone*

Area Code Phone Number

Parent 1 Work Phone

Area Code Phone Number

Parent 1 Cell Phone*

Area Code Phone Number

Parent 1 E-mail*

Parent 1 Address*

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

Parent 2 Name*

First Name Last Name

Parent 2 Home Phone*

Area Code Phone Number

Parent 2 Work Phone

Area Code Phone Number

Parent 2 Cell Phone*

Area Code Phone Number

Parent 2 E-mail*

Parent 2 Address If different from spouse

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

Emergency Information

Emergency Contact 1*

First Name Last Name

Relationship to Child*

Home Phone*

Area Code Phone Number

Cell Phone*

Area Code Phone 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.*

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties. *

I Accept

Full Name*

First Name Last Name

Initials*

I allow photos of my child(ren) to be used to promote Chabad Richmond Hebrew School, and posted on Chabad Richmond Facebook (public group)I allow photos of my child(ren) to be posted on the closed Hebrew School Group

Payment Plan

Tuition Agreement

The following is a tuition agreement. The agreement explains the tuition fees and payments plans. Please read it through carefully. If paying by check or cash, full payment must be submitted to the school office before any child will be permitted to attend classes.

A $100 non-refundable registration fee per child is required. This amount will be deducted from the tuition fee.
The tuition is $700.00 per year per child (this includes dinner, registration & book fee).

Discounts: There is a 10% discount off of the regular tuition for each additional child of the same family. There is a 10% additional discount off your total tuition for each child of another family you successfully introduce to the Chabad Hebrew School.

For those in need of a scholarship please email Rabbi Baitelman at [email protected] and will call you to discuss.

You may choose from the following payment methods:*

PLAN A: You may pay the entire amount in full with a check, cash or credit card.PLAN B: You may pay the annual tuition in two payments of $350 each. First payment in September and the second in January. Payment can be made by check or credit card. Checks must be submitted before the first day of Hebrew SchoolPLAN C: You may pay the annual tuition on a monthly basis on your credit card or by submitting 10 checks of $70.00 each, dated September through June. All checks must be submitted before the first day of Hebrew School.

*

AcceptDo Not Accept

Your FULL name here:*

First Name Last Name

Amount to be charged today:

$

Total

$0.00

My child is doing a one time trial class, if we continue sending him/ her afterwards I'll email or call the office regarding a payment plan.

Payment

Credit Card Check/Cash

Postal / Zip Code

Country

I heard about Chabad's Programs from:

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

Student 1:

Student 2:

Student 3: