Register Online

Register Online
We are currently accepting application forms for children in K - 7th Grade for the 2021-2022 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.
If you would prefer to fill out a paper form and mail it into our office, a PDF can be found here .
Please note that one registration form per child is needed.
We look forward to a wonderful year of FUN, learning, and growth.
Child #1 Profile
Full Name*
First NameLast Name
Hebrew Name
Birth Date*
MonthDayYear
School*
Grade Entering*
Hebrew Reading Proficiency*
NoneSomewhatWell
Previous Jewish Education*
YesNo
Where?
Child #2 Profile
Full Name
First NameLast Name
Hebrew Name
Birth Date
MonthDayYear
School
Grade Entering
Hebrew Reading Proficiency
NoneSomewhatWell
Previous Jewish Education
YesNo
Where?
Child #3 Profile
Full Name
First NameLast Name
Hebrew Name
Birth Date
MonthDayYear
School
Grade Entering
Hebrew Reading Proficiency
NoneSomewhatWell
Previous Jewish Education
YesNo
Where?
Family Information
Father's Full Name*
First NameLast Name
Phone Number
Area CodePhone Number
E-mail
Mother's Full Name*
First NameLast Name
Phone Number
Area CodePhone Number
E-mail

Address*

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

Was the maternal grandmother born Jewish?*
YesNo
Emergency Information
Emergency Contact 1*
Phone*
Emergency Contact 2
Phone
Does your child have any allergies or other medical conditions we should be aware of?*
YesNo
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 JKidz 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, JKidz 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 JKidz Hebrew School activities and that these pictures may be used for marketing purposes.
I accept.
Name:*
Initials:*
We look forward to a wonderful year of FUN, learning, and growth!
Pay Online:
Tuition for the 2021-22 year $950/Child($50 discount for the 2nd and 3rd child)
TUITION FOR THE 2021-22 SCHOOL YEAR:
~~$1000/child + $100 supplies = $1100~~
THANKS TO AN ANONYMOUS DONOR, THE NEXT 16 NEW REGISTRATIONS (AT THE TIME OF POSTING) WILL BE JUST $475 PER CHILD!
No child EVER gets turned away for lack of funds!
This page uses a secure connection and your information will not be shared with anyone.
If you are in need of financial assistance please complete our Scholarship Form at ChabadDE.com/JKidzScholarship .
A minimum $200 deposit is required per child upon registration.
To set up a payment plan, please contact [email protected]
Tuition for the 2021-22 year $950/Child*
1 Child: $4752 Children: $9503 Children: $1425
I would like to help sponsor a child's Jewish education with a tax-deductible donation:
Total Payment (Tuition + Sponsorship):*Should be full amount unless discussed otherwise with Rabbi Motti
$
Total
$0.00

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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Child #1 Profile

Child #2 Profile

Child #3 Profile

Family Information

Emergency Information

Pay Online: