JUDA Hebrew School

JUDA Registration Spring 2021
Child 1 *

First Name Last Name
Birth Date *

Month Day Year
Date
School and Grade Level 2020-2021 School Year, if applicable (School Name, Grade)
Gender *

Male Female
Do you have another child to register?

Yes No
Child 2

First Name Last Name
Birth Date

Month Day Year
Date
School and Grade Level 2020-2021 School Year, if applicable (School Name, Grade)
Gender

Male Female
Do you have another child to register?

Yes No
Child 3

First Name Last Name
Birth Date

Month Day Year
Date
School and Grade Level 2020-2021 School Year (School Name, Grade)
Gender

Male Female
Child(ren)'s Address *

Street Address

Street Address Line 2

City State

Zip Code
Parent/Guardian 1 Name *

First Name Last Name
Parent/Guardian 1 Phone Number *

Area Code Phone Number
Parent/Guardian 1 Email *
example@example.com
Parent/Guardian 2 Name

First Name Last Name
Parent/Guardian 2 Phone Number

Area Code Phone Number
Parent/Guardian 2 Email
example@example.com
Is Parent/Guardian 1 Jewish? *
Is Parent/Guardian 2 Jewish? *
Does your child(ren) have any previous Jewish education? Does your child(ren) read/speak Hebrew?
Is there anything we should know about any of your children (allergies, medical or learning conditions)?
Comments or Questions:
Informed Consent and Acknowledgment

As the parent(s) or legal guardian(s) of the child/ren note above, I/we authorize any adult acting on behalf of Chabad of Austin Inc/JUDA Hebrew School, to hospitalize or secure treatment for my child/ren. I further agree to pay for all charges for that care and/or treatment. It is understood that, if time and circumstances reasonably permit, the Hebrew School will try to communicate with me prior to such treatment. I/we hereby give permission for my child/ren to attend all field trips and outings sponsored by Chabad of Austin Inc/JUDA Hebrew School and be transported to and from the field trips and outings. I also allow my child to be photographed while participating in Hebrew School activities. I/we understand that these photographs may be used for publicity purposes.
Tuition Payment
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Pay now for Spring Session Tution (per child) $ 100.00
If you do not select this option, please remit payment by check or cash before the first class (and click submit below). No family will be turned away due to lack of funds, please contact us for scholarship information.

Choose the amount of children you're registering.

Total $ 0.00
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JUDA Registration Spring 2021