Hebrew School Registration – Chai Center Chabad

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Home
About Us
- About Chai Center Chabad
Rabbi’s Lectures
Adult Education
- Jewish Women’s Circle
Youth
Synagogue
- Kiddush Sponsorship
Events
- Donate
Contact Us

HEBREW SCHOOL REGISTRATION FORM

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Child's Information

Child's Name*

First Last

Hebrew Name

Address*

Street Address City ZIP / Postal Code

Date of Birth*

MM slash DD slash YYYY

Time of Birth (to calculate Hebrew Birthday)

Age as of September 1, 2025:*

Grade entering as of 9/25*

School Attending as of 9/25*

Gender:*

Female

Male

Does student have any learning challenges that we should be aware of?*

Yes

Please describe which learning challenges your child has:

Any allergies or medical condition we should be aware of?*

Yes

Please specify which allergies your child has:

Parents' Information

Student's Father's Name*

First Last

Father's Hebrew Name

Father is Jewish by:

Birth

Converted Orthodox

Converted Other

Not Jewish

Father's Cell Phone Number:*

Father's Email Address:*

Student's Mother's Name*

First Last

Mother's Hebrew Name

Mother is Jewish by:*

Birth

Converted Orthodox

Converted Other

Not Jewish

Mother's Email Address*

Mother's Cell Phone*

Parents Are:

Married

Divorced

Separated

Single Parent

Is the family affiliated with a Synagogue, and if so which one?

Tuition*

$1,400 - one time payment

$700 - 2 payments

Consent*

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of JUDA Hebrew School to facillitate any necessary medical treatment for my child. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in JUDA Hebrew School activities. I acknowledge and agree that these pictures may be used for marketing purposes.*

Total

Credit Card*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

After this form is submitted you will receive an email letting you know if your child has been accepted. Questions or comments? Mrs. Rivkie Bogomilsky (973) 479-5015 or rivkie@chaicenterchabad.org