Hebrew School Registration | www.jewishloudoun.com

Parent 1

First Name *

Last Name *

Email *

Phone Number *

Parent 2

First Name *

Last Name *

Email *

Phone Number *

How many children are you registering? *

Child 1

First Name *

Last Name *

Hebrew Name

Example: David or דוד

Gender *

Birth Date *

Month

Day

Year

Street Address

State/Province

City

Postal Code

Tuition and Fees

The fees will include a $1150 Tuition Fee, a $75 Registration Fee and a $50 Book Fee. For a total of $1275.
Additional Children will get a 10% Sibling Discount of $127.5 off the full amount

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

Tuition $

Book Fee $

Registration Fee $

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

Street Address

State/Province

City

Postal Code

Tuition and Fees

Tuition $

Book Fee $

Registration Fee $

Sibling Discount $

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

Street Address

State/Province

City

Postal Code

Tuition and Fees

Tuition $

Book Fee $

Registration Fee $

Sibling Discount $

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

Chai Discount Code

If you are a Chai club member please contact yehudis at yehudis@jewishloudoun.com for your discount code.

Chai Discount $

If you are enrolling before June 7th use these codes to lock in your Early Bird discount:

1 child use JUDAEARLY for $150 off
2 children use JUDAEARLY2K for $300 off
3 children use JUDAEARLY3K for $450 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 Chabad 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, Chabad 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 Chabad Hebrew School 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

Chabad of Loudoun County