*Last Name
*First Name
Hebrew Name
*Gender Male Female
*Date of Birth
*Address
*City
*Province
*Postal Code
*Home Phone
*School
*Grade entering
Comments
Title --Select Title-- Mr. Dr. Rabbi
First Name
Last Name
Work Phone
Cell Phone
Email
Title --Select Title-- Mrs. Ms. Dr.
*Marital Status --Select -- Married Divorced Widow(er)
*Is Mother Jewish? --Select -- Yes No
If there have been adoptions or conversions in the family, please explain.
Name Phone # Relation
*Emergency 1
Emergency 2
Emergency 3
$50 Non refundable Registration & Book fee will be charged now. Tuition Fee is $675 minus Discounts and does not include the registration fee. Tuition fee can be charged either in one payment on September 1 or in three payment on the first of September, October, and November. For alternative payment plans kindly contact shaina@chabadmaple.com.
2019-20 School Year: September 2019 - May 2020
*Payment Options --Select-- One Payment Three Payments
Total Amount:
A $ 25 discount will be applied to the Tuition Fees for Registrations done before June 15th. A $25 sibling discount and $25 referral discount is also available. Please note referrals in the comment section above.
Only registration fee ($50) will be charged at this time.
Registration Fee
Card Type --Card Type-- Visa MC Amex
*Card Number
*Expiration Date --Month-- 01 02 03 04 05 06 07 08 09 10 11 12 --Year-- 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032
*Security Code
Use Information above
Name on Card
*Billing Address
*Billing Postal Code
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Maple 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, Chabad Maple 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 Chabad Maple Hebrew School and its associates, teachers and agents harmless there from. I/we consent to Chabad Maple Hebrew School’s use of our personal information and of our child/children at its discretion in pursuit of school activities.
I agree to the terms and conditions above
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