We are currently accepting application forms for the 2019-2020 Bat Mitzvah Club . Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, or would like to request a printable registration form please contact us.

Register by June 21 to receive 5% off!! 

Use code EARLYBIRD5    

We look forward to a wonderful year of learning, & excitement.

Student Information

Family Name

Girl's First Name

Hebrew Name

Date of Birth

What school does your child attend?

Synagogue affiliated with

Any conversions or adoptions in the family? Please Explain (If any conversions please type in name of Rabbi) formation

Father's Name

Home Phone

Work Phone

Email Address (home)

Cell

Occupation

Home Address

Home City

Home Province

Home Postal Code

Marital Status Married Separated Divorced

If divorced Stepfather how long

Stepmother how long

Mother's Name

Home Phone

Work Phone

Email Address (home)

Cell

Occupation

Home Address (If different then above)

Home City

Home Province

Home Postal Code

Emergency Contact Information

Please list two contact to be used in case of emergencies

Name 1

Relationship to child

Home Phone

Cell

Name 2

Relationship to child

Home Phone

Cell

Does your daughter have any allergies, other medical conditions or special needs we should be aware of? Yes No If yes, please describe them and indicate special precautions or care needed.

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Bat Mitzvah Club to hospitalize or secure treatment for my/our child, I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Bat Mitzvah Club personnel will try, but are not required, to communicate with me/us prior to such treatment. I/we hereby give permission for my/our child to participate in all school activities, join in class and school trips on and beyond school properties and allow my/our child to be photographed while participating in Hebrew School activities. I/we also understand that all liability and costs resulting from damage to property and/or personal injury caused or attributable to my/our child/children will be my/our responsibility and I/we agree to fully indemnify and save CYN Hebrew School and it’s associates, teachers and agents harmless therefrom. I/we consent to Hallandale Bat Mitzvah club use of our personal information and of our child/children at its discretion in pursuit of school activities.

Date Initial

Tuition Fees

Fee: $635 (includes registration fee) 

Location: 1295 E. Hallandale Beach Blvd

*This is non-refundable and due in full at the time of registration.
Registration must be paid in full at time of registration.

Billing info

Cash Check (We must receive checks within 30 days to be eligible for the discount. Can be post-dated)

Credit Card

Name on card

Card #

Expiry

Promo Code: 

  • Head-checks dated for each of these dates are due at registration.
  • Please make all checks payable to Chabad Hebrew School and submit them together with the registration form.
  • There are no refunds or credits for days missed due to illness, holidays, or family vacations.
  • Charitable tax receipts will be issued for the full amount of all tuition fees paid.

Billing Information

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