Hebrew School Registration 2024-2025

How many children are you registering? *

This is the application for Hebrew School 2024-25. Please note that applications undergo review and acceptance is not guaranteed. A $100 application fee applies per child. If accepted, the $100 fee will apply to tuition, which is $1800/child. If rejected, the $100 fee will be refunded.

Child 1

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Birth Date *

Month

Day

Year

Birth Date Before Sunset *

Adopted? *

Yes

School child is attending in the fall *

Grade child is entering in the fall *

Medical History

List any medications child takes

List any allergies child has to food or medications

Does child need an epi-pen?

any medical, developmental or behavioral issue that we should know about?

Share address of

Registration Fee $

Child 2

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Birth Date *

Month

Day

Year

Birth Date Before Sunset *

Adopted? *

Yes

School child is attending in the fall *

Grade child is entering in the fall *

Medical History

List any medications child takes

List any allergies child has to food or medications

Does child need an epi-pen?

any medical, developmental or behavioral issue that we should know about?

Share address of

Registration Fee $

Child 3

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Birth Date *

Month

Day

Year

Birth Date Before Sunset *

Adopted? *

Yes

School child is attending in the fall *

Grade child is entering in the fall *

Medical History

List any medications child takes

List any allergies child has to food or medications

Does child need an epi-pen?

any medical, developmental or behavioral issue that we should know about?

Share address of

Registration Fee $

Child 4

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Birth Date *

Month

Day

Year

Birth Date Before Sunset *

Adopted? *

Yes

School child is attending in the fall *

Grade child is entering in the fall *

Medical History

List any medications child takes

List any allergies child has to food or medications

Does child need an epi-pen?

any medical, developmental or behavioral issue that we should know about?

Share address of

Registration Fee $

Mother

First Name *

Last Name *

Gender

Street Address *

Street Address Line 2

City *

Postal Code *

State *

Phone Number *

Email *

Is Jewish *

Any conversions in the family? *

Please Explain *

Father

First Name *

Last Name *

Gender

Share address of

Parents are married

Marital Status

Relationship to Father Relationship Type(s)

Street Address

Street Address Line 2

City

Postal Code

State

Kids living with? *

Phone Number *

Email *

Is Jewish *

Delray Jewish Life Center Inc - DBA Chabad of West Delray, Florida