Chabad of Calabasas Hebrew School

Enrollment Form 2019/2020 - 5779

Child's Information

Child's Name

Child's Hebrew Name

Birthday

School Attending

Grade

My child's knowledge of basic Judaism is:

Poor Fair Good

My child:

does not read Hebrew recognizes the Alef-Bet reads Hebrew slowly reads Hebrew well

Family Information

Are the child's biological parents Jewish?

Yes No Only Dad Only Mom

Have there been any conversions or adoptions in the family?

Yes No

If yes, please explain:

Parents Information

Name(s)

Address

City/Zip

Home Phone

Father's Cell Phone #

Mother's Cell Phone #

Email Address(es)

Emergency Contact (other than yourself)

Relationship to you

Home Phone #

Cell Phone #

Does your child(ren) have any allergies (food, medication etc.) that we should be aware of?

Is there anything else you would like us to know about your child/ren and/or your hopes for his or her Hebrew School experience?

Hours: Sundays, 10am-12pm

Please consult the Hebrew School annual calendar (to follow) regularly for off-days.

Annual Tuition: $775.00 per child (includes registration & book fee) + $200 security guard fee per family.

In the event of an emergency, Chabad of Calabasas has my permission to arrange for any necessary first-aid or care by a licensed physician/first-aid worker. Chabad of Calabasas has my permission to use my child(ren)’s photo in its publicity materials.

I have completed the Enrollment Form and have enclosed my payment.

Electronic Signature

Clear