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Returning Student Registration

School Year 2026-27

Returning Student Registration
Family Name*
Street Address
City, State, Zip
Child #1
1. Child's Full Name*
1. Hebrew Name
1. Birth Date*

Month Day Year
1. Grade Entering 08/26*
1. Any changes to medical or any other pertinent information?*

NoYes
1. If yes, please explain changes:
Check here to register another child.
Child #2
2. Child's Full Name
2. Hebrew Name
2. Birth Date

Month Day Year
2. Grade Entering 08/26
2. Any changes to medical or any other pertinent information?

NoYes
2. If yes, please explain changes:
Child #3
3. Child's Full Name
3. Hebrew Name
3. Birth Date

Month Day Year
3. Grade Entering 08/26
3. Any changes to medical or any other pertinent information?

NoYes
3. If yes, please explain changes:
Parents' Information
Father's Name*
Father's E-mail*
Father's Cell*
Mother's Name*
Mother's Email*
Mother's Cell*
Emergency Information
Please list a LOCAL person who may be contacted to pick up your child in case of an emergency when the parents cannot be reached.
Emerg. Contact - Full Name*
Relationship to Child*
Emerg. Contact - Cell Number*
Fees and Payment Information

Registration & Book fee: $50/child
Tuition: $1220
There is a 10% tuition discount for additional children.
Total Tuition and Fees:
I am registering 1 child.
I am registering 2 children.
Tuition & Fees for 1 Child: $1270

One Payment $1270Eight payments: $220 today, then $150 monthly
Tuition & Fees for 2 Children ($1270 + $1150)

One Payment $2420Eight payments: $320 today, then $300 monthly
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%
Indicate Your Choice of Payment Plan

One Payment in FullNine Monthly Installments (September - May)

Payment*

Credit Card Paypal Check

Postal / Zip Code

Country

Comments
Permission*

I hereby permit my child to participate in all school activities and to participate in class and school trips on and beyond school properties. In case of an emergency, I hereby authorize the school to have my child given care by a physician in the manner in which the situation dictates.
Signature*
Should be Empty:

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