Hebrew School Registration

Father

First Name *

Last Name *

Email *

Phone Number *

Is Father Jewish from birth?

Mother

First Name *

Last Name *

Email *

Phone Number *

Is Mother Jewish from birth?

How many children are you registering? *

Child 1

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Gender *

Birth Date *

Month

Day

Year

Birth Date Before Sunset

Yes

Street Address

State/Province

City

ZIP/Postal Code

Hebrew School Sudent Questions

What is the name of the school your child currently attends?

Which grade will your child be entering?

What previous jewish education, if any, does your child have?

Does your child have any allergies or other medical condition that we should be aware of?

Yes

Please describe them and indicate special precautions or care needed.

Additional Notable Information

Emergency Contact Info

Full Name

Phone Number

Relationship to Child

Child 2

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Gender *

Birth Date *

Month

Day

Year

Birth Date Before Sunset

Yes

Street Address

State/Province

City

ZIP/Postal Code

Hebrew School Sudent Questions

What is the name of the school your child currently attends?

Which grade will your child be entering?

What previous jewish education, if any, does your child have?

Does your child have any physical/mental conditions we should be aware of?

Yes

Please elaborate on the physical/mental condition of your child

Additional Notable Information

Emergency Contact Info

Full Name

Phone Number

Relationship to Child

Child 3

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Gender *

Birth Date *

Month

Day

Year

Birth Date Before Sunset

Yes

Street Address

State/Province

City

ZIP/Postal Code

Hebrew School Sudent Questions

What is the name of the school your child currently attends?

Which grade will your child be entering?

What previous jewish education, if any, does your child have?

Does your child have any physical/mental conditions we should be aware of?

Yes

Please elaborate on the physical/mental condition of your child

Additional Notable Information

Emergency Contact Info

Full Name

Phone Number

Relationship to Child

Child 4

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Gender *

Birth Date *

Month

Day

Year

Birth Date Before Sunset

Yes

Street Address

State/Province

City

ZIP/Postal Code

Hebrew School Sudent Questions

What is the name of the school your child currently attends?

Which grade will your child be entering?

What previous jewish education, if any, does your child have?

Does your child have any physical/mental conditions we should be aware of?

Yes

Please elaborate on the physical/mental condition of your child

Additional Notable Information

Emergency Contact Info

Full Name

Phone Number

Relationship to Child

Jewish Background

Are the child's biological parents Jewish by birth? *

Have there been any conversions or adoptions in your family? *

Please explain: *

Tuition and Fees

The fees will include a $1200 Tuition Fee, a $75 Registration Fee and a $50 Book Fee. For a total of $1325.
Additional Children will get a Sibling Discount of $10% off their $1200 Tuition

No child will be turned down based on tuition costs. Please email Rabbi Cohen directly at rabbi@jewishloudoun.com so that we can ensure your child can attend JUDA.

Tuition Child 1 $

Tuition Child 2 $

Tuition Child 3 $

Tuition Child 4 $

Total Registration Fee $

Total Book Fee $

Sibling Discount $

If you are enrolling before Apr 23rd use the JUDAEARLY code to lock in your Early Bird 5% discount:

1 child get $60 off
2 children gets $120 off
3 children gets $180 off
4 children gets $240 off

Early Discount Code

Early Bird Discount $

Terms of Agreement**

As the parent(s) or legal guardian(s) of the above child(s), I/we authorize any adult acting on behalf of JUDA - Judaism through the Arts 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, JUDA - Judaism through the Arts 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 JUDA - Judaism through the Arts activities and that these pictures may be used for marketing purposes.

Terms and Conditions *

Yes

Current Date

Month

Day

Year

Note: Tuition can be paid either in full or quarterly

Chabad of Loudoun Hebrew School Registration Form

2023-2024

Chabad of Loudoun County