Registration

We are currently accepting application forms for the 2019/20 school year!
If you have any questions or concerns you'd like to discuss with us, please email raizelsac@gmail.com

Please note that one registration form per child is needed.
We look forward to a wonderful year of learning and growth!

Child's Name*

First NameLast Name

Hebrew Name

Birth Date*

MonthDayYear

School*

Previous Jewish Education

Grade entering*

Hebrew Reading Proficiency*

NoneKnows the Hebrew lettersKnows some vowelsReads well

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Father's Name*

First NameLast Name

Father Cell

Area CodePhone Number

Mother's Name*

First NameLast Name

Mother Cell

Area CodePhone Number

Primary contact email*

Jewish

MotherFatherBothIn the process of converting

Conversions or adoptions?

YesNo

If yes, please explain:

Emergency Contact*

First NameLast Name

Phone Number*

Area CodePhone Number

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad of Sacramento Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad of Sacramento Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school grounds and allow my child to be photographed while participating in Chabad of Sacramento Hebrew School activities and that these pictures may be used for marketing purposes.

I Agree - Full Name*

First NameLast Name

Initials*

Registration Fee*You can pay full tuition now, or pay the second half in January at the start of the second semester.

$500$250

Total

$0.00

Payment

Credit Card Paypal Check

Postal / Zip Code

Country

Parents Information

Emergency Information

Payment