New Student Registration

Please fill out ALL fields of this form.
If you have any questions or concerns you'd like to discuss, please contact us.
We look forward to a wonderful year of learning and growth.
One registration form is needed per child.
Returning? Please click here to register returning students.
Student information
Full Name*
First NameLast Name
Hebrew Name*
Birth Date*
MonthDayYear
Medical: allergies or medical conditions/
Grade Entering*
Hebrew Reading Proficiency*
NoneSomewhatGood
Has had Jewish Education before?*
YesNo
if yes, where?
Is the biological mother of the child Jewish?*
YesNo
Is the maternal grandmother of the child Jewish?*
YesNo
Were there any conversions or adoptions in your family?*
YesNo
Parent information
Home Phone
Area CodePhone Number
Father's Full Name*
First NameLast Name
Father's Cellphone*
Area CodePhone Number
Father's E-mail*
Mother's Full Name*
First NameLast Name
Mother's Cellphone*
Area CodePhone Number
Mother's E-mail*

Address*

In case of Emergency
If we can't reach you.
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.
Medical Authorization*
Yes, I/We Accept
Initial*
Emergency contact 1*Name & phone
Emergency contact 2*Name & phone
Parent Volunteers
Parent involvement is key to the growth and excitement at VCHS.
Please choose at least one volunteering opportunity*
Class Parent Role - GeneralSukkah Party - Thursday, October 13Chanukah Gift Wrap - Sunday, December 11Tu B'shvat Fair - Sunday, January 16Hamentash Bake - Sunday, March 5Purim Party - Wednesday, March 7Pesach Event - Sunday, March 26End-Of-Year Celebration - Sunday, May 21
Payment
Program you are registering for*
Payment Schedule*
Full - Paid by start of Hebrew School2 Installments - September & January4 Installments - Sep. Nov. Jan. Mar
Total
$0.00

Payment*Card will be charged on your selected schedule above.

Credit Card Check

Postal / Zip Code

Country

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