Name of Child:
*
Date of birth:
*
-
Month
-
Day
Year
Date Picker Icon
Time of Birth:
day - before sunset
night - after sunset
Hebrew date of birth:
Child's Grade:
*
Please Select
kindergarden
1st
2nd
3rd
4th
5th
6th
Jewish name:
Jewish name of mother:
Please tick according to your child's ability. 0-no ability and 5-best.
0
1
2
3
4
5
My child can read Hebrew
My child can write Hebrew
My child can speak Hebrew
My child can recognize the Hebrew Alphabet
We speak Hebrew at home
Does your child have any allergy or medical condition we need to know about?
Contact person (name)
*
Phone Number
*
-
Area Code
Phone Number
Whatsapp Number (if different)
-
Area Code
Phone Number
Address
*
I want to get updates and photos of my child from school, and you can use and upload my child's photo on public posts, website, Facebook etc..
*
yes
no
Below is the schedule (we might have changes according to registration)
Winter-spring semester, Monday and Wednesday, 45 minutes class
Comments about schedule:
I would like to join Sunday school program as well (with additional charge of $50 for semester)
yes, let me know more details about it
no, thank you
Total:
Payment
*
cash - $150
credit card - below
Registration Fee
prev
next
( X )
USD
Description
Credit Card
comments
Submit
Should be Empty: