Register Online

We are currently accepting application forms for the school year.

Please fill out ALL fields of this form. If you have any questions or concerns

Please feel free to Contact Us with any questions.

If you would prefer to fill out this paper and mail it into our office,

a PDF can be found here. Registration form.pdf

Please note that one registration form per child is needed.

After you submit your registration form below, you may make a payment or gift online at

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

Student Profile
Hebrew Name
Grade Entering
Hebrew Reading Proficiency None    Somewhat    Well
Previous Jewish Education Yes            No

Parent Information
Father's  Hebrew/English Name

Mother's  Hebrew/English Name

Is the Natural Mother of the child Jewish?

Has there been a conversion or adoption in the family? if yes please specify

Email Address


Emergency Information
Emergency Contact 1
Emergency Contact 2

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 and allow my child to be

photographed while participating in Chabad Hebrew School activities and

that these pictures may be used for marketing purposes.

I Accept   

Name:     Initials:

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