Register - Chabad-Lubavitch of Pittsford
« Back to Chabad-Lubavitch of Pittsford

We are currently accepting application forms for the 2017-2018 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 contact us.

Click here if you want a printable form that you can return by mail.

Student Information
Child 1:      
Child's Name Hebrew Name
Date of Birth School
Grade Entering Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No Where?
Please Indicate your child’s Art Club preference (Number 1-3): Dance/Music Art Cooking    
       
Child 2: (if applicable)    
Child's Name Hebrew School
Date of Birth School
Grade Entering Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education? Yes No Where?
Please Indicate your child’s Art Club preference (Number 1-3): Dance/Music Art Cooking    
       
Is the natural mother and maternal grandmother of the child Jewish? Yes No
Were there any conversions or adoptions in your family (children, parents, grandparents)? If Yes, please explain.

 
Parent Information
Father's Name Email
Work Phone Cell Phone
Mother's Name Email
Work Phone Cell Phone
Address City
State Zip
 
Emergency Informaion
Emergency Contact Home Phone
Work Phone Cell Phone
Doctor Address
Phone Number    
 
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.
 
Parent Involvement
Yes! I am able to help organize/ volunteer at:
Family Shabbat Dinner CHS Chanukah Party
CHS Purim Carnival End of Year Celebration
Field Trips    
 
Payment Information

Chabad Hebrew School of the Arts Early-Bird Tuition Rate for the complete school year 2017-18 is $600 per child (rate for 2+ children $575 each) plus a $45 registration fee per family. Early Register Special:  Registration fee will be waived if received by June 4, 2017 (online or mail form)

 

Remember: Our goal is to provide every Jewish child with an excellent Hebrew School experience. If you need to arrange a payment plan for this year's tuition payments- please contact Hebrew School Administrator Rabbi Yitzi Hein before August 1st to arrange a payment schedule - yhein@jewishpittsford.com or 585.340.7545 

Tuition Payment Method Tuition Checks can be mailed to 21 Lincoln Ave Pittsford, NY 14534.
Card Number Billing Address
Expiration CVV Code What's This?
 
 
Terms of Enrollment

As the parent(s) or legal guardian of the above child(ren), 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 attend all field trips and outings sponsored by Chabad Hebrew School.

I also allow for my child's pictures in school to be featured on the Hebrew School Website/Facebook Page. 

I Accept Name: Initials:
 

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

Secure This page uses 128 bit SSL encryption to keep your data secure.