CHABAD OF PEABODY HEBREW SCHOOL OF THE ARTS 

ONLINE REGISTRATION: 2018-2019 YEAR

$100 DEPOSIT PER FAMILY IS REQUIRED. 

 

STUDENT INFORMATION (Student #2)
First Name   Last Name
Hebrew Name   D.O.B.
School   Grade Entering as of 9/1
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes  No If yes - where? 

STUDENT INFORMATION (Student #3)
First Name   Last Name
Hebrew Name   D.O.B.
School   Grade Entering as of 9/1
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education

Yes No If yes - where?

 

PARENT INFORMATION
Father's Name   Father's Cell    
Mother's Name   Mother's Cell
Address   City, State, Zip
City State Zip
Alternate/Home Phone   Email

 

Were there any conversions or adoptions in the family? Yes No
If yes, please explain:

EMERGENCY INFORMATION
Emergency Contact 1   Phone
Emergency Contact 2   Phone


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.



As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Hebrew School of the Arts 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, 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 participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept

Name:
Initials:

PAYMENT OPTIONS

• Hebrew School Tuition (Kindergarten and up) $850 tuition, $25 supplies fee.

• Hebrew School Tuition Pre-School Program (ages 3-5 potty trained) $725 tuition, $25 supplies fee.

I understand that a $100 deposit, per family, is required for registration to be charged to my credit card.

I will mail my $100 deposit upon filling out this form. Payments should be made payable to Chabad of Peabody and mailed to P.O. Box 2154, Peabody, MA 01960.

Name on card   Card Type
Charge Amnt. enter $150 deposit or you will be charged the amount you enter here   Card Number
Exp. Date   CVV Code 3 digits on back of card
I would like to pay

Will pay annual amount in full via credi

Quarterly by credit card. Payments to be charged on 9/1, 12/1, 3/1, and 5/1.

Invoice me

Special Arrangements - I will be in touch with the Rabbi

     

Our program does not require any family membership at a synagogue and all students and their families are welcome to attend services at Chabad at no additional cost.· Although our programs are open to families of all backgrounds and affiliations, and no family will be denied because of inability to pay, and we don't require separate membership for our synagogue, our synagogue is traditional and life cycle events, such as Bar and Bat Mitzvah, can only be celebrated by children of a Jewish mother or those converted under Halachic auspices.
We look forward to a wonderful year of learning and growth!