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Child's Information
Name
Last
Hebrew Name
DOB
School
Grade 2016-17
Day Signing Up For Sunday
Hebrew Reading Proficiency None Somewhat Well
Hebrew Speaking Proficien None Somewhat Well
Previous Jewish Education Yes No
Where?
Parent Information
Home Phone
Father's Name
Hebrew Name
Cell/Work Phone
Mother's Name
Hebrew Name
Cell/Work Phone
Address
City
Province
Postal Code
Email Address
Are any of the parents converted? Indicate which.
If the above answer is yes, where was the conversion performed?
Emergency Information
Emergency Contact 1
Phone
Relationship
Emergency Contact 2
Phone
Relationship

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.

Vaccinations Current Yes No
Date of last tetanus shot


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!

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Upcoming events
Jun. 28, 2017
Join Rabbi Mendy as he delves into the deeper meaning behind the Parshah.

Class is free
Text book optional $20.00
Jun. 29, 2017
Mitzvah Class - 6:00pm-7:00pm
Join us as we will be discussing the 613 Commandments in the Torah and their rationale.
This class is facilitated by Moshe Meir (The Mitzvah Man) ...
Jun. 29, 2017
Kabbalah For Beginners-7:30pm-9:00pm
Classes that bring Kabbalah and Jewish philosophy down to earth and makes them relevant to our own lives. "Kabbalah for Beginners - GPS for the Soul" ...
Jul. 06, 2017
Mitzvah Class - 6:00pm-7:00pm
Join us as we will be discussing the 613 Commandments in the Torah and their rationale.
This class is facilitated by Moshe Meir (The Mitzvah Man) ...