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CHS Family Registration 25 26

CHS Family Registration

Directors: Rabbi Yehuda and Dina Kantor

Registration 2025-2026
Each Hebrew School Family Must Complete This Form.
This form is for the first Hebrew School Student of your family. If you are registering more than one child, please complete this form for the first child, and then an Additional Hebrew School Student Form (shortened) for each of the other students.
FAMILY INFORMATION
Family Name*
Home Number*

Area Code Phone Number

Home Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Are there any conversions in your family (including parents / grandparents)?
If yes, paternal or maternal?*

PaternalMaternalNo Conversions
Father's Information
Father's Name*
First Name Last Name
Father's Hebrew Name
Father's Cell #*

Area Code Phone Number
Father's Work #*

Area Code Phone Number
Father's E-mail*
Mother's Information
Mother's Name*
First Name Last Name
Mother's Hebrew Name
Mother's Cell #*

Area Code Phone Number
Mother's Work #*

Area Code Phone Number
Mother's E-mail*
EMERGENCY CONTACT
Full Name*
First Name Last Name
Relationship*
Phone Number*

Area Code Phone Number
STUDENT INFORMATION
Full Name*
First Name Last Name
Hebrew Name
Called By*
Age*
Birth Date*

Month Day Year
Grade (September 2025)*
Previous Hebrew Education *
Number of Years *
Please list any health concerns, medications, or general information we need to know*
Does your child have an IEP or does he/ she receive any services at school? It is important for us to know this so we can best support your child.*

YesNo
TUITION FEE
Students in Grades 3 through 6, have class on both Sundays and Tuesdays. We know schedules are full and challenging yet wish to emphasize the old aphorism - "the more you put in the more you take out". No doubt, the more we invest in our children’s Jewish Education, the more they will benefit and grow!

If you / your child can only commit to once a week, please check off the once a week option and we’ll take it from there.

Kindergarten Students (Graduate from Little Gan - Special discount): $875

K-Grade 2: Sunday Only $1,750

Grades 3-6: Sunday AND Tuesday $2,450

Grades 3-6 Sunday OR Tuesday $1,750

Grade 7 Sunday $1,750

PARTNERSHIP DISCOUNT: (Click here to become a partner)

K-Grade 2: Sunday Only $1,500

Grades 3-6: Sunday AND Tuesday $1,950

Grades 3-6 Sunday OR Tuesday $1,500

Grade 7 Sunday $1,500

*Times: Sunday 9:30-11:30 AM & Tuesday 4:00-6:00 PM
PAYMENTS
Select one:*

Kindergarten (Little Gan Student)K-Grade 2: Sunday ONLYGrades 3-6 Sunday AND TuesdayGrades 3-6 Sunday ONLYGrades 3-6 Tuesday ONLYGrade 7 Sunday ONLY
PARTNERSHIP DISCOUNT
Thank you so much for becoming a partner / member. Together, we will ensure a vibrant community and a sustainable future to ensure that Am Yisrael Chai isn’t a mere slogan rather the unyielding and joyous truth - Dor L’dor!

Want to know what partnership is and why you should join? Click here to read more about it and join!
Join Partnership --2025/26*

YesNo
Due Today:* Select one:

$500 Deposit - Mandatory at time of applying.Full Payment Little Gan Kindergarten Students: $875Full Payment for 1 day $1,750Full Payment for 2 days $2,450Partnership Discount: Full payment for 1 day $1,500Partnership Discount: Full payment for 2 days $1,950
Mandatory Security Fee:* Our office will follow up regarding this payment per family.

$300 per family
I would like to help a child! CHS Scholarship Fund*

YesNot Today
Donation Amount

$0
Total

$0.00
Almost There!
- If you selected $500 deposit payment today, the office will contact you with a payment schedule for your remaining balance.

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

Please include all names of siblings being registered in CHS
Check off:

I hereby permit my Child(ren) to participate in all school activities and join in school trips on and beyond school properties. In case of emergency, I hereby authorize the school to have my child taken care of by a physician in any way the situation may call for. (Please note - checking this box constitutes a signed authorization.)I am willing to assist in school activities. Please contact me.
Should be Empty:

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Each Hebrew School Family Must Complete This Form.

FAMILY INFORMATION

Father's Information

Mother's Information

EMERGENCY CONTACT

STUDENT INFORMATION

TUITION FEE

PAYMENTS

PARTNERSHIP DISCOUNT

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