Chai Hebrew School Returning Student 2021/2022

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Family Name

* How many recurring students would you like to register?

Child 1

* Child 1 - First Name

* Child 1 - Last Name

* Month Child 1 Born

* Child 1 - Date of Birth

* Child 1 - Time of Birth

Please Select OneMorningAfter Nightfall

Child 1 Hebrew Name

Child 1 Gender

Please Select OneMaleFemale

Child 1 Grade Entering

Child 2

* Child 2 - First Name

* Child 2 - Last Name

* Month Child 2 Born

* Child 2 - Date of Birth

* Child 2 - Time of Birth

Please Select OneMorningAfter Nightfall

Child 2 Hebrew Name

* Child 2 Gender

Please select OneMaleFemale

Child 2 Grade Entering

Child 3

* Child 3 - First Name

* Child 3 - Last Name

* Month Child 3 Born

* Child 3 - Date of Birth

* Child 3 - Time of Birth

Please Select OneMorningAfter Nightfall

Child 3 Hebrew Name

* Child 3 Gender

Please select OneMaleFemale

Child 3 Grade Entering

Child 4

* Child 4 - First Name

* Child 4 - Last Name

* Month Child 4 Born

* Child 4 - Date of Birth

* Child 4 - Time of Birth

Please Select OneMorningAfter Nightfall

Child 4 Hebrew Name

* Child 4 Gender

Please select OneMaleFemale

Child 4 Grade Entering

* Email

Total

Wed, 15 January 2025 15 Tevet 5785

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