Register Online - Chabad of South Broward

Hebrew Club Online Registration

& Bar Mitzvah Club Registration

We are currently accepting application forms for the 2022-2023 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please email [email protected]

For returning students,click herefor our online quick & easy registration form.

We look forward to a wonderful year of learning and growth.

New families will automatically receive 50% off Kindergarten & 1st Grade Tuition!

Student Information

Full Name*

First NameLast Name

Hebrew Name

Gender*

FemaleMale

Birth Date*

MonthDayYear

Was your child born after nightfall?*

YesNo

Grade Entering*

School

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Can your child read Hebrew?*

YesNoSomewhat

Does your child have previous Jewish education?*

YesNo

Please describe

Is there anything we should know about your child?

Synagogue affiliated with

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

YesNo

Please provide details. Include the Rabbi's name for conversion

Is the child's mother Jewish?*

YesNo

Sibling 1 Name

First NameLast Name

Sibling 1 Birth Date

MonthDayYear

Was sibling 1 born after nightfall?

YesNo

Sibling 1 Grade Entering

Sibling 2 Full Name

First NameLast Name

Sibling 2 Birth Date

MonthDayYear

Was Sibling 2 born after nighfall?

YesNo

Sibling 2 Grade Entering

Classmate Requests

Parent Information

Father's Name*

PrefixFirst NameLast Name

Father's Work Number*

Area CodePhone Number

Father's Cell Number*

Area CodePhone Number

E-mail*

Marital Status*

MarriedSeparatedDivorcedWidowed

Mother's Name*

PrefixFirst NameLast Name

E-mail*

Mother's Cell Number*

Area CodePhone Number

Mother's Home/Work Number

Area CodePhone Number

Emergency Contact Information

Name 1*

First NameLast Name

Cell Phone Number 1*

Area CodePhone Number

Relationship to Child 1*

Full Name 2

First NameLast Name

Cell Phone Number 2

Area CodePhone Number

Relationship to Child 2

Medical

Does your child have any allergies, other medical conditions or special needs we should be aware of?*

YesNo

If yes, please describe them and indicate special precautions or care needed.

Is your child/ren up to date with their vaccinations?*

YesNo

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Hallandale Hebrew School 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, Hallandale Hebrew School 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 Hebrew School and it’s associates, teachers and agents harmless therefrom. I/we consent to Hallandale Hebrew School’s use of our personal information and of our child/children at its discretion in pursuit of school activities.

Signature*

First NameLast Name

MonthDayYear

at HourMinutes

Tuition Fees

Sunday 10:00 AM - 12:15 PM

Registration Fee: $150.00

Security Fee: $100.00

Tuition: $625.00

Total: $875.00

Registration & security fee must be paid in full at time of registration and not included in tuition fees.

Payment Methods

You may choose from the following payment methods:

The tuition can be paid in full when registering your child.

Alternatively, it could be broken up into three equal payments. 1st payment is due September 15. 2nd payment is due October 15. 3rd payment is due November 15.

•Head-checks dated for each of these dates are due at registration. Please make all checks payable to Hallandale Hebrew School and submit them together with the registration form.

•Refunds for children withdrawing from school before the end of the school year will be pro-rated up to February 1st provided that the school office is given 30 days written notice and does not include the registration fee.

•Tuition refunds will not be granted to children withdrawing from school after November 1st.

•There are no refunds or credits for days missed due to illness, holidays, or family vacations.

Billing Information

Payment*

Credit Card Check

Postal / Zip Code

Country

Payment Plan*

Pay in fullSplit into 3 payments

I would like to assist a child who cannot afford Hebrew School Education

Yes

Amount