Returning Student Registration

Student Information
This form is for RETURNING STUDENTS ONLY. If you want to register a new student, CLICK HERE
Number of Children*
Full Name*
First Name Last Name
Hebrew Name*
School*
Grade Entering 2024-25*
Child 2
Full Name 2*
First Name Last Name
Hebrew Name*
School*
Grade Entering 2024-25*
Child 3
Full Name 3*
First Name Last Name
Hebrew Name*
School*
Grade Entering 2024-25*
Emergency Contact Info
Persons to be contacted in case of an emergency when parents cannot be reached
Emergency Contact*
First Name Last Name
Emergency Number*

Area Code Phone Number
Relationship to the Child*
CONFIDENTIAL: Any allergies or medical condition we should be aware of?*

YesNo
If YES please describe. Please specify which Child if more than one.
Confidential: Does child have any learning or physical disabilities? (SHARING THIS INFORMATION WITH US ENABLES US TO CREATE A HEBREW SCHOOL ENVIRONMENT IN WHICH YOUR CHILD CAN THRIVE)*

YesNo
Tuition Schedule
These terms will apply should your child be accepted.
Program & Tuition Agreement
I hereby confirm my child’s enrollment in Aleph Bay Hebrew School.
I represent that I am the custodial parent or legal guardian of the child that I am enrolling and that the information
I have provided is true and correct. I agree to Aleph Bay Hebrew School's terms and conditions as outlined in the Parent Handbook.
I fully understand that this enrollment, as part of my commitment to a long-term Jewish education at Aleph Bay, is accepted only on the basis of the full year program, and agree to pay the full annual or Monthly fees accordingly. I understand that no refunds or adjustments will be made for absences including, but not limited to, illness or vacation.
I fully understand that by choosing monthly payment, Aleph Bay will charge my card automatically every month (upon acceptance).
Costs:

Tuition Fees cover all weekly activities, snacks, drinks, and most trips.

Tuition: $900
Deposit & Supplies: $150
Discounts: Please check off all those that apply. Discount will not be displayed on total price. It will be manually deducted.

Earlybird Discount: $50 off tuition (Per Child) if registered by July 1Family Discount: 10% off each additional sibling.
Payment Plan*

I would like to pay now in fullI would like to pay half now and the balance by January 1, 20259 Equal Payments charged the 1st of each month (September-May) (5% additional fee)I need a more flexible payment plan. I understand that my application will not be processed until a plan is in place.
Payment Terms: If a different plan is needed
Donate to the Scholarship Fund for families in need

$36$100$180$360$540$1000
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%
Your card will only be charged for the deposit fee. Monthly and Annual Payments will be Charged starting September 1st.

Payment* Payment will NOT be charged at this time. It will be set-up based on your preferences checked above.

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

CCV*
3 or 4 Digit Security Code
Important - Permissions
1. PARENTAL CONSENT: I hereby give consent for my child to participate in all activities at Chabad Hebrew School unless I advise you otherwise in writing. *

I Accept
2. PAYMENT AND CANCELLATION: Payment in full must be received at time of registration. For all other payment arrangements, a payment schedule must be coordinated with our office and post-dated checks submitted at time of registration. Hebrew School tuition is non-refundable.*

I Accept
3. MEDICAL CARE: In case of emergency, I hereby give permission to the physician selected by the Hebrew School Director, to hospitalize, to secure proper treatment for and to order injection, anesthesia, or other procedure deemed necessary for my child by an M.D. as named on this form or if unavailable another M.D.. Every effort will be made to contact the parent / guardian and emergency contacts first. Should it be necessary for the well being of the student to utilize outside medical or dental services all expenses involved will be paid for by the parent. To the best of my knowledge, my child is in good health and I will notify Chabad if he/she is exposed to any infectious diseases.*

I Accept
4. IMAGES, ETC.: Permission is hereby given to use in promoting Hebrew School and in other ventures directly relating to Chabad (i) digital, photographic and video images or likenesses of student; audio of student; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by student or originating from Hebrew School or related activity. *

I Accept
5. INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless Chabad of Sheepshead Bay and its officers, servants or assigns from any liability concerning our child’s involvement in Hebrew School activities and further agree that the use of any premises during Hebrew School is made at the risk of the registrant.*

I Accept
SIGNATURE*
My e-signature will be legally binding as a printed signature.
Date*

Month Day Year
Additional Comments
Should be Empty:

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Student Information

Child 2

Child 3

Emergency Contact Info

Tuition Schedule

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