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Register

Register

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ONLINE REGISTRATION FORM

Registration is now open for 2017-18!

 

NEW! TO RE-REGISTER WITH NO NEW INFORMATION, PLEASE CLICK HERE


Registration fees:

  • Sunday School: $199 1st child, $189 2nd child
  • Edinburgh, Elizabeth Ballantyne, Hillcrest and Souvenir: $199 1st child, $189, 2nd child
  • Beechwood and Westpark: $220 1st child $200 2nd child 
  • Lunch Program: $69

 Bring a friend Sunday School & After School: $50 discount per family.

 


Please Note:  

 -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.

-One registration form per child is needed. 


 

We look forward to a wonderful year of learning! 

Student Profile
 

First Name *

Last Name *
Hebrew Name
DOB *
Time of birth (am or pm)
Student email
School Attending *
Grade Entering *
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No Where?
Home Phone Number *
Parent Information
 
Father's Name *
Phone *

Father's Hebrew Name

Business Name & Address
Position
Father's Email Address *
Mother's Name *
Phone *
Mother's Hebrew Name
Business Name & Address
Position
Mother's Email Address *
Address *
City *

Postal Code *

Parent's Status Single Married Divorced Widowed
Language Spoken at Home
Congregation Affiliation
Emergency Information
 
Emergency Contact 1 *
Phone *
Emergency Contact 2 *
Phone *
Medicare Card # *
Brothers & Sisters
If there are more siblings, please choose the 2 closest in age to the student applying
Name
Birth date

School Attending

Name
Birth date
School Attending
Payment

Please indicate form of payment:

Check Cash Credit Card, please fill out below:

Name on card
Card Number

Expiration date

Amount

In order to ensure that every child gets picked up safely, please fill in the following information:

Does your child walk home by him/herself? Yes No
Does your child go to late class? Yes No
If not, who picks him/her up?
What is this person's relation to the child?
Additional information:

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.

How did you hear about us?

* Which program are you registering for?

If you are registering for Thursday Lunch Program, please specify: 

 

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Free Hebrew for Juniors 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, Free Hebrew for Juniors 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 Free Hebrew activities and that these pictures may be used for marketing purposes. I agree not to register my child(ren) in any other program (i.e. hockey, swimming etc.) during the same hours as Hebrew school.

I Accept

Name: Initials:

We look forward to a wonderful year of learning!

 

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