CHABAD MARKHAM HEBREW SCHOOL

REGISTRATION FORM 2018-19

83 GREEN LANE, THORNHILL, ON L3T 6K6    (905) 886-0420 x221     info@chabadmarkham.org

First day of school: Sunday, September 16, 2018

School Hours: Sundays, 9:30 am – 12:30 pm

FOR INFORMATION ON THE BAT MITZVAH CLUB OR BAR MITZVAH VENTURE CLUB
 CLICK HERE

PLEASE NOTE: Each child must have their own registration.

Child Information

First Name

  

Hebrew Name:
Middle:   Gender: F M

Last Name

  

Birthdate:
(MM/DD/YYYY)
Address   City, State, Zip
      Home Phone:
Name of Public School child is attending:   Grade starting in September
Parents are:

Married
Divorced
Separated
Other

   Child lives with: (both parents/mother/ father/other)

Are there any allergies or medical conditions we should be aware of? If yes, please explain:
Mother's Information

First Name

  

Hebrew Name

Last Name

  

Email
Address   City, State, Zip
Home Phone (if different from above)   Cell Phone
Work Phone      
Father's Information
First Name
  Hebrew Name
Last Name:   Email
Address   City, State, Zip
Home Phone (if different from above)   Cell Phone
Work Phone      
Affiliation

Synagogue your family is affiliated with:

   Are you a member? Yes No

Is the natural mother of the child Jewish:

 Yes No    

If no, please explain:
Were there any conversions/adoptions in your family: Yes No      

If yes, please explain:

PLEASE NOTE: All conversions must be in accordance with Orthodox Halachic standards.
In case of emergency

Name of local relative or friend (not living at same address)

  

Relationship to child

Home Phone

  

Cell Phone
 


The above information is true to the best of my knowledge. I confirm the enrolment of my child in Chabad Markham Hebrew School and I permit my child to participate in all school activities, join in class/school trips on and off of school property. I allow pictures to be taken of my child and to be published online. In case of emergency, I hereby authorize Chabad Markham Hebrew School to take whatever measures the situation may call for.

Parent/Guardian signature (Please type name):

Date:

Tuition Information

EARLY REGISTRATION DISCOUNT:
SAVE $50.00 PER CHILD IF REGISTERED BY JUNE 3, 2018.

MEMBERS DISCOUNT:
$50.00 discount per family for members of Chabad Lubavitch of Markham

ADDITIONAL SIBLING DISCOUNT:
Additional registered siblings receive a $50.00 discount per child.

2018-19 Tuition:

$750 per child (payable over ten months between September 2018 and June 2019) plus $75.00 registration fee per child, payable upon submission of registration forms.

Child's Name: Grade:

$750

 $75 Registration Fee

Discounts: (click all that apply):

CLOM Members subtract $50.00 off of total.

The child being registered is an additional sibling - subtract $50 off of total.

 
Payment Information
CC Type   Card Number
Name on the Card      
Total Amount   Exp Date
   

 

 

Limited scholarships are available through our Scholarship Fund.
Subsidy applications are available through the Hebrew School office. Requests will be evaluated by a scholarship committee.

Thank you for registering with Chabad Markham Hebrew School!

Please wait for a confirmation by e-mail to ensure your registration has been received (please allow at least one business day for a confirmation).