Tenafly Chabad Academy Returning Registration Form 2021-22

TCA Returning Student Registration Form

2021-2022

Please complete a separate form for each child that you are registering.

If you are registering your child for 1st grade, please use the new student application .

STUDENT INFORMATION

Last Name *

First Name *

Middle Name

Hebrew Name

Likes to be called

DOB *

Month Day Year

Hebrew Birthdate

(please use this Hebrew Birthdate calculator: https://www.hebcal.com/converter/ )

Grade Entering, Select your Choice Below *

1st Graders must register with the new student form

Address *

Address 2

City *

State *

Zip code *

Home Phone Number *

Area Code Phone Number

Primary Email *

example@example.com

FAMILY INFORMATION

Mother/Guardian 1

Title *

First Name *

Last Name *

Cell Phone *

E-mail *

Work Phone

Area Code Phone Number

Father/Guardian 2

Title *

First Name *

Last Name *

Cell Phone *

E-mail *

Work Phone

Area Code Phone Number

Additional Guardian Information (If different from Parents)

Title

First Name

Last Name

Relationship to Child

Home Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

E-mail

Cell Phone

Area Code Phone Number

Work Phone

Area Code Phone Number

Parents' Marital Status

Please check special family circumstances:

Married Stepfather Stepmother Divorced Widowed

If applicable, please attach court order custody agreement

Browse Files

Photo Permission: I hereby grant permission for photography and videography of my child’s activities at the school or any activities related to the school for public relations purposes (social media). I agree that I am to receive no compensation for my child’s appearance and that this participation confers on me no ownership rights whatsoever. (Please mark yes or no) *

Yes No

Trip Permission: I give permission for my child to participate in walking trips within the school’s neighborhood. *

Yes No

Synagogue Affiliation

Name of the Synagogue, City & State

Name of the Rabbi

Grandparent Information:

*

No changes Changes Below

Paternal Grandparent Names

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Email

example@example.com

Maternal Grandparent Names

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Email

example@example.com

Emergency Contacts other than Parents:

Emergency Contact #1

Name *

First Name Last Name

Relationship *

Phone *

Area Code Phone Number

Cell *

Area Code Phone Number

Emergency Contact #2

Name *

First Name Last Name

Relationship *

Phone *

Area Code Phone Number

Cell *

Area Code Phone Number

By signing and submitting this form, I attest that the above information is all correct.

Signature of Parent 1: *

Please type your name

Date *

Signature of Parent 2:

Please type your name

Today's Date

Date

Thank you for considering Tenafly Chabad Academy for your family. Your application will reviewed by our admissions team and we look forward to being in touch.

Registration Fee through February 22nd: $770 per student

After March 9th Registration Fee: $1,200

After May 1st Registration Fee: $1,800

Upon clicking "Submit" you will be redirected to the secured payment processing website. Please be advised that without payment your registration will remain on hold and the fees will increase as per the registration fee schedule.

Email

example@example.com