Printed fromChabadMidSuffolk.com
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Registration 2021

  • Hebrew School Registration 2021/2022

  • CHILD'S INFO:



  • Parents

  • PARENT 1:

  • PARENT 2:

  • HOME:

  • Medical/Emergency Information

  • EMERGENCY CONTACT:

  • MEDICAL & OTHER NEEDS:

  • PHYSICIAN:

  • General Information

  • AUTHORIZATION FOR ANOTHER PERSON TO PICK UP MY CHILD:

  • TRIPS:

  • I give permission for my child/ren to participate on class trips throughout the school year:

  • Tuition & Billing

  • K-2nd Grade   
              Member: $750
              Non member: $1,000

    3rd - 6th Grade  
             Member: $850
             Non member: $1,100

    CTeen Jr. - 7th Grade
             Member: $1,050
             Non member: $1,500

  • PROGRAM & TUITION AGREEMENTS:

    I hereby confirm my child’s enrollment in Chabad of Mid-Suffolk Hebrew School.

    I represent that I am the custodial parent or legal guardian of the child that I am enrolling and that the information I have provided is true and correct. 

    I fully understand that this enrollment, as part of my commitment to a long-term Jewish education at Hebrew School, is accepted only on the basis of the full year program, and agree to pay the full annual fees accordingly. I understand that no refunds or adjustments will be made for absences including, but not limited to, illness or vacation.

    I agree to the following Mandatory Fees:
    $54 Student Activity Fee per family
    $100 Security Fee per family 

  • Pick a Date
  • PAYMENT OPTIONS:

  •   
    Credit Card
    Billing Address
  • Disclaimer

  • Accident: As the parent(s) or legal guardian of the above child/ren, 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 of Mid-Suffolk Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment.

    Trips and Outings: I hereby give permission for my child to attend and participate in all trips and outings organized as part of the program by Chabad of Mid-Suffolk Hebrew School.

    Privacy: I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Chabad of Mid-Suffolk Hebrew School website or for promotion of our program.

  • Pick a Date
  • Should be Empty:
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