Chabad Hebrew School
Registration Form 5777 / 2016-2017
(ages 5+, Sundays 11:00-12:30)

First Name
 Last Name
Age
 School
Address
City/Zip
Home Phone Number
Parents Email Address
Mother Cell Number
Father Cell Number
Emergency Name Emergency Contact #
Hebrew Name
Allergies (if any)

Birthday

Comments

The fee for Hebrew School is $500.00.
Please discuss payment options with Rabbi Lieberman.

Looking forward to a great year together!