Family Information
Family Name    
Address City
Zip Code Home Phone
Father's Name Hebrew if Available
Address (if different) City
Zip Code Home Phone
Father's Email Father's Cell Phone
Father is Jewish by Birth Jewish by Choice Other 
Mother's Name Hebrew if Available
Address (if different) City
Zip Code Home Phone
Mother's Email Mother's Cell Phone
Mother is Jewish by Birth Jewish by Choice Other 
Marital Status of Parents Does someone other than the parent(s) care for your child(ren)?
If yes, please give name Phone Number
       
Child Information
1. Child's Name

Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family    
2. Child's Name Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family    
3. Child's Name Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family    
4. Child's Name Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family    
Please name/age siblings who are not being enrolled in the Hebrew School for the year 2019-20
 
Tuition & Payment
PICK A PROGRAM:
SPECIAL DISCOUNT: Full payment by August 10, 2020 entitles you to a 5% discount!
I'd like my children to join Hebrew School this year via: In Person Session
Sundays 9:00-10:30
Hebrew School at Home
Sundays 11:00-12:00
 
Grades K-5 Sundays $795
  Number of children    
Grades 6 & 7 Sundays AND Wednesdays $975
  Number of children 
 
  Total:
PAYMENT:    
I wish to pay by: Check Credit/Debit Card
Checks should be made payable to Breitman Family Hebrew School (BFHS), and sent to Chabad Center at 3048 Valley Road in Basking Ridge, New Jersey, 07920. A fee of $25 will be charged for a return check.
Card Holder Name Card Type
Credit Card Number CVV
Exp Date Total Paying Now
Enrollment Agreement
To enroll your child(ren) in Chabad Hebrew School, all forms must be completed and sent in to the school. Your application will not be processed without the required forms and fees.
Full payment due at the beginning of the school year, September 13, 2020.
Enrollment is considered to be for the entire scholastic year. There will be no refunds even if the child is absent due to illness, holidays, vacations and snow days, or should the parents decide to withdraw the child from the program.
In the event that tuition is not paid, BFHS reserves the right to debit your Credit/Debit card, plus a $25 processing fee
DISPOSITION
Parent acknowledges that Chabad Hebrew School serves children who are able to function successfully in a group setting. If, in the judgment of the school's Director, the child is not able to function in a group setting, the parent may be asked to withdraw the child. In the event that the parent is request to withdraw the child, the Director will work with the parent to identify possible alternative programs suitable for the child.
RELEASE OF INFORMATION AND PHOTOGRAPHS
Parents allow for child(ren)'s picture to be used for internal PR mailing and website where name is not given. Parents allow for child(ren)'s photograph/name released to newspapers where last name will not be given. If not, please contact us.
By submitting and initialing this form, parents accept the terms outlined above. Both parents must initial.
Mother's Initials Date
Father's Initials Date
 

BREITMAN FAMILY HEBREW SCHOOL AT THE CHABAD JEWISH CENTER