Chai Hebrew School (Sunday School) Registration 5782 - Form

Registration 2021-2022

Child's Information

* How many children are you registering?

* Child 1 - First Name

Child 1 - Middle Name

* Child 1 - Last Name

Child 1 - Hebrew Name

* Month Child 1 Born

* Child 1- Date of Birth

* Child 1 - Time of Birth:

Please Select OneMorningAfter Nightfall

* Child 1 - Gender

Please Select OneMaleFemale

* Child 1 - School Attending

Child 1 Name of School

Child 1 Grade Entering

Child 1 Grade Entering.

Child 1 - Previous Hebrew School

Please select oneYesNo

Child 1 Name of Hebrew School

Child 1 Hebrew Language Ability

Child 1 Health Card #

* Child 1 - Allergies

Please Select OneNoYes

Child 1 - Describe Allergy

* Child 2 - First Name

Child 2 - Middle Name

* Child 2 - Last name

Child 2 - Hebrew Name

* Month Child 2 Born

* Child 2 Date of Birth

* Child 2 - Time of Birth

Please Select OneMorningAfter Nightfall

* Child 2 - Gender

Please Select OneMaleFemale

* Child 2- School Attending

Child 2 Name of School

Child 2 Grade Entering

Child 2 Grade Entering.

Child 2 - Previous Hebrew School

Please Select OneNoYes

Child 2 - Name of Hebrew School

Child 2 - Hebrew Language Ability

Child 2 - Health Card #

* Child 2 - Allergies

Please select oneNoYes

Child 2 - Describe Allergy

* Child 3 - First Name

Child 3 - Middle Name

* Child 3 - Last name

Child 3 - Hebrew Name

* Month Child 3 Born

* Child 3 - Date of Birth

* Child 3 - Time of Birth

Please Select OneMorningAfter Nightfall

* Child 3 - Gender

Please Select OneMaleFemale

* Child 3- School Attending

Child 3 Name of School

Child 3 - Grade Entering

Child 3 Grade Entering.

Child 3- Previous Hebrew School

Please Select OneNoYes

Child 3 - Name of Hebrew School

Child 3 - Hebrew Language Ability

Child 3 - Health Card #

* Child 3 - Allergies

Please Select OneNoYes

Child 3- Describe Allergy

* Child 4- First Name

Child 4- Middle Name

* Child 4 - Last name

Child 4 - Hebrew Name

* Month Child 4 Born

* Child 4 - Date of Birth

* Child 4 - Time of Birth:

Please Select OneMorningAfter Nightfall

* Child 4 - Gender

Please Select OneMaleFemale

* Child 4- School Attending

Child 4 Name of School

Child 4- Grade Entering

Child 4 Grade Entering.

Child 4- Previous Hebrew School

Please Select OneNoYes

Child 4 - Name of Hebrew School

Child 4 - Hebrew Language Ability

Child4 - Health Card #

* Child 4 - Allergies

Please Select OneYesNo

Child 4- Describe Allergy

Medical Information

* Physician's Name

* Physician's Phone number

Parent 1's Information

* First Name

* Last Name

Hebrew Name

Home Phone Number

* Cell Phone

* Parent 1's Email

Parent 2's Information

* First Name

* Last Name

Hebrew Name

Home Phone Number

* Cell Phone

Parent 2's Email

Family Information

Marital Status

* person responsible for pick up

Please specify

* Address

* City

* Postal Code

* Are you affiliated with a synagogue?

Please Select OneYesNo

Enter Name of Synagogue

* Are there any conversions or adoptions in your family?

Please Select OneNoYes

Please Explain

* Jewish Law mandates that we ask if the biological mother of the child is Jewish

Please Select OneNoYes

Please Explain

Emergency information

Emergency Contact #1:

* First & Last Name

* Relationship to Child

Home Phone Number

* Cell Number

As the parent (s) or legal guardian of the above child, I / we authorize any adult acting on behalf of Chai Hebrew School to hospitalize or secure treatment for my / our child. I / we further agree to pay all charges for that care or treatment. It is understood that if time and circumstances reasonably permit, Chai Hebrew School personnel will try, but are not required, to communicate with me/us prior to such treatment. I/we hereby give permission for my/our child to participate in all school activities, join in class and school trips on and beyond school properties and allow my/our child to be photographed while participating in Hebrew School activities. I/we also understand that all liability and costs resulting from damage to property and/or personal injury caused or attributable to my/our child/children will be my/our responsibility and I/we agree to fully indemnify and save Chai Hebrew School and its associates, teachers and agents harmless there from. I/we consent to Chai Hebrew School’s use of our personal information and of our child/children at its discretion in pursuit of school activities.

* I agree to the terms and conditions above

I agree to the terms and conditions above

* Parent / Guardian Signature

* Date

* Preferred email for Confirmation. Please provide an email address that is checked regularly.

We will process your application shortly,

Please choose from the following tuition options.

When you receive an acceptance email you will be prompted to process tuition payment.

2021 - 2022 Tuition:

$800 per child

+ $50 per child registration & book fee (non refundable).

* Tuition Options: Please check all that apply.

A Tax deductible receipt will be issued for all tuition fees.

There are scholarships available.

Please e-mail info@chaihebrewschool.ca to check qualification and request a form.

Total Registration Fee $50 per child