Register

We are currently accepting application forms for the 2017-2018 school year.

Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

Please note that one registration form per child is needed. We look forward to a wonderful year of learning and growth.

Tuition is $700 - Scholarships Available
Minimum $50 Payment Req'd For Registration to be complete

Child's Name*

First NameLast Name

Hebrew Name

School

Birth Date

MonthDayYear

Previous Jewish education

Where?

Grade entering*As of September 2017

Father's Full Name*

First NameLast Name

Father's Cell Phone Number

Area CodePhone Number

Father's E-mail

Mother's Full Name*

First NameLast Name

Mother's E-mail

Mother's Cell Phone Number

Area CodePhone Number

These biological parents of the child were born Jewish*Select all that apply

MotherFatherOther - Contact Me

Are there any conversions in the family?*

YesNo

Are there any adoptions in the family?*

YesNo

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.

Terms of Agreement

As the parent(s) or legal guardian of the above child(ren), I/we authorize any adult acting on behalf of Chabad of Harford County or Chabad's Harford Hebrew School 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,Chabad of Harford County or Chabad's Harford 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.

As the parent(s) or legal guardian of the above child(ren), I/we authorize allow our child to be photographed while participating in Chabad of Harford County's activities and that these pictures may be used for any and all marketing purposes and release Chabad of Harford County and any of its officers, agents, employees and volunteers from liability for such use.

I/We agree that after acceptance to Chabad of Harford County's Harford Hebrew School we will complete and submit a tuition agreement.

No one is ever turned away due to inability to pay as long as they have completed a Tuition agreement and met with the Rabbi or Director in advance. Please note: a Tuition agreement is required to attend Hebrew School

I/we are aware that acceptance to Chabad of Harford County or Chabad's Harford Hebrew School is not an endorsement of the Childs Halachic status as a Jew.

If necessary, the Child's status will need to be verified prior to any Bar/Bat Mitzvah being performed at Chabad.

*

I accept

Full Name*

First NameLast Name

Initials*

Payment PlanIf you can't pay full please enter what you can commit to in the box

I plan on paying the full tuition amount of $700Please Contact Me to Arrange a Payment Plan

Total

$0.00

I would like to pay today: Full amount$50.00 minimum $

Payment

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Student Profile

Parent Information

Payment Information