Register

Early Bird Date

Month Day Year
Rates

Early Bird Discount: Before June 1 – 25% Discount

K	Free
Grades 1–5	Members \| $800 Non-Members \| $1,100
Bar/Bat Mitzvah Club 6–7	Members \| $900 Non-Members \| $1,200
+ $100 Security Fee per Family + $50 Registration Fee per Child

Registration Details
I'm currently paying membership to Chabad of Mid-Suffolk*

YesNo
Have you registered your child(ren) with us before?*

YesNo
Click here for more information about being a member of the Chabad.
Synagogue Affiliated with (if any)
Refer a family, receive a $75 discount!
Have a family to refer?*

YesNo
Family Name*
Family's E-mail*
Family's Phone Number*

Area Code Phone Number
The deduction will be factored in when your referred family registers.
Parent's Info
Mother's Name*
First Name Last Name
Hebrew Name
Mother's Phone Number*

Area Code Phone Number
Mother's E-mail*
I would like to receive news and updates by email
Father's Name
First Name Last Name
Hebrew Name
Father's E-mail
Father's Phone Number

Area Code Phone Number
Father's Occupation
Home Phone

Area Code Phone Number
Marital Status*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Child's Info
For how many child(ren)
Child's Name*
First Name Last Name
Hebrew Name*
Child’s Headshot*
Birth Date*

Month Day Year
Time of Birth*
Hour Minutes
Place of Birth
Age
Gender*

MaleFemale
What grade are they entering in September 2026?*
Program (Members)*
Program (Members)* Early Bird
Program (Non-Members)*
Program (Non-Members)* Early Bird
School Attended
Any considerations such as learning difficulty's at school we should be aware of (Confidential)
Does your child read basic Hebrew?*

NoSomewhatWell
What is their sweater size?*

XSLSXLM
(2) Child's Name*
First Name Last Name
(2) Hebrew Name*
(2) Child’s Headshot*
(2) Birth Date*

Month Day Year
(2) Time of Birth*
Hour Minutes
(2) Place of Birth
(2) Age
(2) Gender*

MaleFemale
(2) What grade are they entering in September 2026?*
(2) Program (Members)*
(2) Program (Members)* Early Bird
(2) Program (Non-Members)*
(2) Program (Non-Members)* Early Bird
(2) School Attended
(2) Any considerations such as learning disorders or difficulty at school we should be aware of (Confidential)
(2) Does your child read basic Hebrew?*

NoSomewhatWell
(2) What is their sweater size?*

XSLSXLM
(3) Child's Name*
First Name Last Name
(3) Hebrew Name*
(3) Child’s Headshot*
(3) Birth Date*

Month Day Year
(3) Time of Birth*
Hour Minutes
(3) Place of Birth
(3) Age
(3) Gender*

MaleFemale
(3) What grade are they entering in September 2026?*
(3) Program (Members)*
(3) Program (Members)* Early Bird
(3) Program (Non-Members)*
(3) Program (Non-Members)* Early Bird
(3) School Attended
(3) Any considerations such as learning disorders or difficulty at school we should be aware of (Confidential)
(3) Does your child read basic Hebrew?*

NoSomewhatWell
(3) What is their sweater size?*

XSLSXLM
Is the natural mother of the child(ren) Jewish?*

YesNo
Were there any conversion or adoption in your family (mother, maternal grandmother etc)?*

YesNo
Please provide details:*
Please note: All conversions must be made through a registered Beth Din that is certified by the Chief Rabbinate of Israel. We do not Bar or Bat Mitzvah anyone whose mother is not Jewish by Israel’s Chief Rabbinate Halachic standards.
Emergency Contact
Emergency Contact 1*
First Name Last Name
Phone Number*

Area Code Phone Number
Relationship to Child(ren)*
Please specify:*
Emergency Contact 2
First Name Last Name
Phone Number

Area Code Phone Number
Relationship to Child(ren)
Please specify:
Does your child have any allergies or other medical conditions we should be aware of?
*

By registering, I acknowledge and give consent for photos of my child(ren) to be taken during Hebrew School and shared on social media for promotional purposes.
Security Fee
Choose Payment Option*

One-Time Payment10 Monthly Payments (Aug-May)
Your first tuition installment will be due in August 2026. A minimum registration fee of $50 per child is required at the time of registration.
Total

$0.00

I would like to pay today:Full amount$50.00 minimum$
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Should be Empty:

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Rates

Registration Details

Parent's Info

Child's Info

Emergency Contact