Registration

JUDA Registration
Registration for JUDA Hebrew School of the Arts Calendar Year 2021-22 is now open!
For new students, in addition to filling out the form below, please call/email Nechama at 347.563.4480 or [email protected] to set up a quick interview. We want to meet you and your child so we can best cater our program to suit their needs!
Registration will be confirmed once the interview takes place.
Tuition: $800
*Includes all registration and fees.

For scholarships or payment plans, please reach out to Rabbi Zalman at 651.998.9298.
Student Information
Child's Full Name*
First NameLast Name
Child's Hebrew Name*
• Exact time of day child was born? (To determine Childs Hebrew Birthday)**
Birth Date*
MonthDayYear
Child's age as of September*
Grade entering in September*
School*
Previous Jewish Education*

Address where child resides*

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

Does your child have any allergies or other medical condition we should be aware of?*
YesNo
If yes, please describe them and indicate special precautions or care needed.
Any considerations, such as learning disorder or difficulty, the school should be aware of?
Register Second Child
Register Second Child
Child's Full Name*
First NameLast Name
Child's Hebrew Name*
• Exact time of day child was born? (To determine Childs Hebrew Birthday)**
Birth Date*
MonthDayYear
Child's age as of September*
Grade entering in September*
School*
Previous Jewish Education*
Does your child have any allergies or other medical condition we should be aware of?*
YesNo
If yes, please describe them and indicate special precautions or care needed.
Any considerations, such as learning disorder or difficulty, the school should be aware of?
Parents Information
Father's Name*
First NameLast Name
Father's Cell*
Area CodePhone Number
Father's E-mail*
Mother's Name*
First NameLast Name
Mother's Cell*
Area CodePhone Number
Mother's Email*
Jewish Lineage
Please mark off for each of the following family members yes or no if they are Jewish:
Father*
YesNo
Mother*
YesNo
Paternal Grandfather*
YesNo
Paternal Grandmother*
YesNo
Maternal Grandfather*
YesNo
Maternal Grandmother*
YesNo
Were there any conversions or adoptions in the family?*
YesNo
If yes, please specify who
Please e-mail all information and documentation to the director at J[email protected]
Emergency Contacts
Emergency Contact #1 Name*
First NameLast Name
Relationship*
Phone Number*
Area CodePhone Number
Emergency Contact #2*
First NameLast Name
Relationship*
Phone Number*
Area CodePhone Number
Medical Information
Doctor Name/Office*
Doctor Phone Number*
Area CodePhone Number
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad JUDA 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 JUDA 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 properties and allow my child to be photographed while participating in Chabad JUDA activities and that these pictures may be used for marketing purposes
I accept*
Yes
I would like to receive news and updates by email
How did your hear about JUDA?**
How would you like to receive updates with regards to Hebrew School ?*
TextWhatsappEmail
Payment
Your payment will not be processed until registration is confirmed.
Tuition Fee
One Child $800Two Children $1600
Total
$1600.00

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

CVV
Should be Empty:

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Student Information

Register Second Child

Parents Information

Jewish Lineage

Emergency Contacts

Medical Information

Payment