Parent Information

Name*

First Name Last Name

Updated Info*

New Phone Number*

New E-mail*

New Address*

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

Child's New Medication/Allergies*

New Emergency Contact

Full Name

First Name Last Name

Phone Number

Child Information

Name*

First Name Last Name

Jewish Name*

Grade entering in September 2026*

Parental Consent

Consent: *

1. PARENTAL CONSENT: I hereby give consent for my child to participate in all activities at Chabad Hebrew School unless I advise you otherwise in writing.2. PAYMENT AND CANCELLATION: Payment in full must be received at time of registration. For all other payment arrangements, a payment schedule must be coordinated with our office and post-dated checks submitted at time of registration. Hebrew School tuition is non-refundable.3. MEDICAL CARE: In case of emergency, I hereby give permission to the physician selected by the Hebrew School Director, to hospitalize, to secure proper treatment for and to order injection, anesthesia, or other procedure deemed necessary for my child by an M.D. as named on this form or if unavailable another M.D.. Every effort will be made to contact the parent / guardian and emergency contacts first. Should it be necessary for the well being of the student to utilize outside medical or dental services all expenses involved will be paid for by the parent. To the best of my knowledge, my child is in good health and I will notify Chabad if he/she is exposed to any infectious diseases.4. IMAGES, ETC.: Permission is hereby given to use in promoting Hebrew School and in other ventures directly relating to Chabad (i) digital, photographic and video images or likenesses of student; audio of student; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by student or originating from Hebrew School or related activity.5. INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless Chabad of NW Bergen County and its officers, servants or assigns from any liability concerning our child’s involvement in Hebrew School activities and further agree that the use of any premises during Hebrew School is made at the risk of the registrant.

Tuition

Registration fee*

$100 - By June 1, 2026$200 - By July 1, 2026$300 - After July 2, 2026

Tuition Prices:*

Request Tuition Assistance

Manadatory Security Fund* $100 Minimum Required

Scholarship Partners

Donate to the Scholarship Fund for families in need

Payment Details

Total

$0.00

Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment Plan*

Pay in FullPayment divided over 4 months starting June

Payment* Payment will NOT be processed at this time. Card will be charged based on your selections above

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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

Re-Registration

Parent Information

New Emergency Contact

Child Information

Parental Consent

Tuition

Scholarship Partners

Payment Details

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