Student Register

CHABAD HEBREW SCHOOL OF MIAMI SHORES REGISTRATION 2024-2025
Thank you for choosing Chabad Hebrew School of Miami Shores for your child! All new families are required to participate in a family meeting prior to completing their registration. If you have not yet attended a family meeting, please email [email protected] to schedule your meeting.
Please note your registration is only complete after a confirmation email is sent to you. Feel free to email us at [email protected] or call 513-578-7171 with any questions you may have.
STUDENT INFORMATION
Child's Name*
First Name Last Name
Hebrew Name
Birth Date*

Month Day Year
Approximate Time of Birth This info used to determine their Hebrew Birthday
Hour Minutes
Grade Entering*
School*
SECOND CHIILD
Child's Name
First Name Last Name
Hebrew Name
Birth Date

Month Day Year
Approximate Time of Birth
Hour Minutes
Grade Entering
School
THIRD CHILD
Child's Name
First Name Last Name
Hebrew Name
Birthday an Approximate Time of Birth

Month Day Year
at Hour Minutes
Grade Entering
School
PARENTS INFORMATION

Address*

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

Father's Name*
First Name Last Name
Father's Cell*

Area Code Phone Number
Father's E-mail*
Mother's Name*
First Name Last Name
Mother's Cell*

Area Code Phone Number
Mother's E-mail*
RELIGIOUS AND EDUCATIONAL HISTORY
Previous Jewish Education
Does your child have any learning difficulties with general studies?*
If yes, please describe:
Is Mother*

Jewish by birthConverted
If converted, please specify Rabbinic Authorization:
Is Maternal Grandmother*

Jewish by birthConverted
If converted, please specify Rabbinic Authorization:
MEDICAL HISTORY
Are there any special medical, allergy or other information that I should be aware of?
Emergency Contact*
First Name Last Name
Phone Number*

Area Code Phone Number
Relation to Student*
Accident & Privacy Declaration:

Accident: As the parent or legal guardian of the above listed child, I authorize any adult acting on behalf of Chabad of Miami Shores Hebrew School/Club 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 Miami Shores Hebrew School/Club personnel will try, but are not required, to communicate with me prior to such treatment.

Privacy: I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Chabad of Miami Shores Hebrew School/Club website or for promotion of our program. I give permission for our family contact information to be shared with other families.
Authorization*

Click to confirm consent
Parents Signature*
TUITION
Tuition for Hebrew School is $900 for the year. This includes registration and book fees.

There are two payment options:
1) Pay in full.
2) Pay $90 registration fee and then set up automatic payments for $90 on the first of every month (September 2023-May 2024). Total, including registration fee = $900.

10% discount for additional children in same family.
Synagogue membership is not required.

Scholarships available. No child will be turned away due to lack of funds.
Please email [email protected] to inquire.
Payment Plan

1) Monthly - $90 registration fee, then $90 a month (per child)2) 1 Child Full - $9003) 2 Children Full - $1,7104) 3 Children Full - $2,5205) Scholarship Request - $90 registration fee6) Mail in check
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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