Online Hebrew School Registration with Credit Card

We are currently accepting application forms for the 2018-2019 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

To pay by check, please print out mail-in registration here and send in/drop off to Chabad Pittsford 21 Lincoln Ave, Pittsford, NY 14534 before August 15th.

Student Information
Child 1:      
Child's Name Hebrew Name
Date of Birth School
Grade Entering Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No Where?
Please Indicate your child’s Art Club preference (Number 1-3): Dance/Music Art Cooking    
       
Child 2: (if applicable)    
Child's Name Hebrew School
Date of Birth School
Grade Entering Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education? Yes No Where?
Please Indicate your child’s Art Club preference (Number 1-3): Dance/Music Art Cooking    
       
Is the natural mother and maternal grandmother of the child Jewish? Yes No
Were there any conversions or adoptions in your family (children, parents, grandparents)? If Yes, please explain.

 
Parent Information
Father's Name Email
Work Phone Cell Phone
Mother's Name Email
Work Phone Cell Phone
Address City
State Zip
 
Emergency Informaion
Emergency Contact Home Phone
Work Phone Cell Phone
Doctor Address
Phone Number    
 
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.
 
Parent Involvement
Yes! I am able to help organize/ volunteer at:
Family Shabbat Dinner CHS Chanukah Party
CHS Purim Carnival End of Year Celebration
Field Trips    
 
Payment Information

Chabad Hebrew School of the Arts Tuition Rate for the complete school year 2018-19 is $600 per child (rate for 2+ children $575 each) plus a $50 registration fee per family.

 

Remember: Our goal is to provide every Jewish child with an excellent Hebrew School experience. If you need to arrange a payment plan for this year's tuition payments- please contact Hebrew School Administrator Rabbi Yitzi Hein before August 1st to arrange a payment schedule - yhein@jewishpittsford.com or 585.340.7545 

Tuition Payment Method
Card Number Billing Address
Expiration CVV Code What's This?
 
 
Terms of Enrollment

As the parent(s) or legal guardian of the above child(ren), I/we authorize any adult acting on behalf of Chabad Hebrew School 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 Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment.

I hereby give permission for my child to attend all field trips and outings sponsored by Chabad Hebrew School.

I also allow for my child's pictures in school to be featured on the Hebrew School Website/Facebook Page. 

I Accept Name: Initials:
 

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