Register Online - Chabad of South Broward
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Hebrew Club Online Registration

 

 

We are currently accepting application forms for the 2017-2018 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, or would like to request a printable registration form, please contact us.


For returning students,

Click here for our online quick & easy registration form.

 

Please note that one registration form per child is needed.

We look forward to a wonderful year of learning and growth.

Student Information

 
Family Name Child's First Name

Hebrew Name

Gender Male Female
Date of Birth    
   

Does your child speak/understand Hebrew?

None Somewhat Well
Does your child have previous Jewish education? Yes No
If Yes please describe
What school does your child attend?

Has your child ever had a psychological assessment? Yes No

If yes, date:
Is there anything else we should know about your child?
Synagogue affiliated with  
Have there been any conversions or adoptions in the family, if yes please explain?(For Conversions, please type in the Rabbi's name)
Please name other children that you are registering:  
Name Age & Date of Birth
Name Age & Date of Birth
Please place my child with the following friends
   

Parent Information

 
Father's Name Home Phone
Work Phone Email address (home)
Cell Occupation
Home Address Home City
Home Province Home Postal Code
Marital Status Married Separated Divorced
  If divorced Stepfather how long
    Stepmother how long
Mother's Name Home Phone
Work Phone Email Address (home)
Cell Occupation
Home Address (If different then above) Home City
Home Province Home Postal Code
   

Emergency Contact Information

 
     
Please list two contact to be used in case of emergencies  
Name 1 Relationship to child
Home Phone Cell
Name 2 Relationship to child
Home Phone Cell

 

   

Confidential

 
Does your child have any allergies, other medical conditions or special needs we should be aware of?
Yes No 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 Hallandale Hebrew School to hospitalize or secure treatment for my/our child, I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Hallandale 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 Hebrew School and it’s associates, teachers and agents harmless therefrom. I/we consent to Hallandale Hebrew School’s use of our personal information and of our child/children at its discretion in pursuit of school activities.

Date Initial
     

Tuition Fees

Click one box Day *Reg & Book Fee Tuition

Total

 

Sunday 10:00 -12:15 pm

$150.00

$620.00

$770.00

           

*This is non-refundable and due in full at the time of registration.
Registration & book fee must be paid in full at time of registration and not included in tuition fees.

       

Payment Methods

   

You may choose from the following payment methods:

The tuition can be paid in full when registering your child.

 
Alternatively, it could be broken up into three equal payments, but only with checks.
  • 1st payment is due August 15.
  • 2nd payment is due September 15.
  • 3rd payment is due October 15.
  • Head-checks dated for each of these dates are due at registration.
  • Please make all checks payable to Hallandale Hebrew School and submit them together with the registration form.
  • Refunds for children withdrawing from school before the end of the school year will be pro-rated up to February 1 provided that the school office is given 30 days written notice and does not include the registration fee. Tuition refunds will not be granted to children withdrawing from school after November 1st. There are no refunds or credits for days missed due to illness, holidays, or family vacations.
  • Charitable tax receipts will be issued for the full amount of all tuition fees paid.

Billing Information

 
I would like to assist a child who cannot afford Hebrew School Education.
 
Cash Check (Applications will be processed upon receiving of payment)
Credit Card    
Name on card    
Card # Expiry
cvv security code #

I heard about the Hallandale Hebrew School Hebrew Club from:
(if you are registering before July 1st the $50 will automatically be credited)
 

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