Hebrew School Registration

Address*

Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Parents Information
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 Hebrew Name
Mother Jewish by:*

BirthChoice
Mother's Cell*

Area Code Phone Number
Mother's E-mail*
Best way to send Bar Mitzva Club updates:**

Cell PhoneEmailHandout
I am willing to assist in Bar Mitzva Club activities, please contact me
Payment
The fee for the full year beginning October 4, 2026 and ending on June 20, 2027 is a total of $1,800.00 per child, charged as $200 per month.
Today I would like to pay the:*

Pay in full - $1,800 nowMonthly installments- $200 now
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

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