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Chabad Hebrew School Durham Region

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Hebrew School Registration

General Information
Child #1 Name:*
First Name Last Name
Hebrew Name:*
Date of Birth:*

Month Day Year
Grade entering in September:*
If SK (please write in notes)
Choose one option:*

Hebrew SchoolBar/Bat Mitzvah
Child #2 Name:
First Name Last Name
Hebrew Name:
Date of Birth:

Month Day Year
Grade entering in September:
Choose one option:

Hebrew SchoolBar/Bat Mitzvah
Child #3 Name:
First Name Last Name
Hebrew Name:
Date of Birth:

Month Day Year
Grade entering in September:
Choose one option:

Hebrew SchoolBar/Bat Mitzvah
Educational Information:
Child #1 Previous Education:*
Child #1:*

Does not read HebrewCan recognize Hebrew LettersReads Slowly
Child #2 Previous Education:
Child #2:

Does not read HebrewCan recognize Hebrew LettersReads Slowly
Child #3 Previous Education:
Child #3:

Does not read HebrewCan recognize Hebrew LettersReads Slowly
Emergency Contact Information:
Full Name:*
First Name Last Name
Relationship:*
Phone Number:*

Area Code Phone Number
Family Information:
Father's Name*
First Name Last Name
Hebrew Name

Address*

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

Phone Number*

Area Code Phone Number
Cell Number*

Area Code Phone Number
E-mail*
Occupation:*
Mother's Name*
First Name Last Name
Hebrew Name

Address*

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

Phone Number*

Area Code Phone Number
Cell Number*

Area Code Phone Number
E-mail*
Occupation:*
Paternal Grandparents Name:*

Address*

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

Maternal Grandparents Name:*

Address*

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

Were there any conversions or adoptions in you family? If yes, please explain:*
Are the natural parents of the child/ren Jewish?*

FatherMotherBoth
Medical Information:
Does your child have any learning or behavior diagnosis? If yes, please explain how we can support your child.*
*

Chabad Hebrew School has my permission to arrange for any necessary first aid or care by a licensed physician for my child while he/she is attending school.
Tuition Fee for 2025-26:
$650 + $75 book fee

Price goes up after June 15th!
$700 + $75 book fee

20% discount will be applied to second and third child.
Tuition:*

1 Child2 Children (sibling discount)3 Children (sibling discount)
Payment Plan*

Pay in full todayPay in 3 payments on the 1st of each month, first payment today.
Total (Full payment due by Sept. 1st)

$0.00

I would like to pay today:Full amount$75.00 minimum$
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

Credit Card Cheque - Interac

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