Registration

Student Details
View the full schedule here.
How many children are you registering?*
First Child
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
Grade Going Into for 25-26 School Year:
Can your child read basic Hebrew?

YesYes, with difficultyNo
Has your child been previously enrolled in a Hebrew/Jewish educational program?

YesNo
If yes, please specify:
Does the child have any allergies or illnesses that we should know about?*

YesNo
If yes, please specify:
Does your child take medication for ADHD on a daily basis?*

YesNo
2nd Child
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
Grade Going Into for 25-26 School Year:
Can your child read basic Hebrew?

YesYes, with difficultyNo
Has your child been previously enrolled in a Hebrew/Jewish educational program?

YesNo
If yes, please specify:
Does the child have any allergies or illnesses that we should know about?*

YesNo
If yes, please specify:
Does your child take medication for ADHD on a daily basis?*

YesNo
Third Child
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
Grade Going Into for 25-26 School Year:
Can your child read basic Hebrew?

YesYes, with difficultyNo
Has your child been previously enrolled in a Hebrew/Jewish educational program?

YesNo
If yes, please specify:
Does the child have any allergies or illnesses that we should know about?*

YesNo
If yes, please specify:
Does your child take medication for ADHD on a daily basis?*

YesNo
Parent Details
Father's Name*
First Name Last Name
Father's Number*
Mother's Name*
First Name Last Name
Mother's Number*
Family E-mail*
Were there any conversions and/or adoptions in the family?*

YesNo
If yes, please specify:
Synagogue Affiliation
Agreements
As the parent(s) or legal guardian of the above child, in case of emergency, I/we authorize any adult acting on behalf of Hebrew Kids Club 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 permit, Hebrew Kids Club personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Hebrew Kids Club activities and that these pictures may be used for marketing purposes.
*

I Accept
Initials*
Tuition
$700 (all books included) + $75 Registation Fee
- ~~$50 OFF - Early Bird Discount Until August 31st.~~
- $40 OFF - Sibling Discount (discount is for the second and third sibling)
Payment Schedule* 1 Child

Pay the full balance of $700 + $75 today. Total $775Pay the registration fee of $75 and half of the total ($350) today and pay the remaining balance on Feb. 1, 2026. Today's total $4257 Monthly Payments of $100 each. Today's total $175 ($100 + Registration Fee)
Payment Schedule* 2 Children

Pay the full balance of $1360 + $150 today. Total $1,510Pay the registration fee of $150 and half of the total ($680) today and pay the remaining balance on Feb. 1, 2026. Today's total $8307 Monthly Payments of $194 each. Today's total $344 ($94 + Registration Fee)
Payment Schedule* 3 Children

Pay the full balance of $2,020 + $225 today. Total $2,245Pay the registration fee of $225 and half of the total ($1,010) today and pay the remaining balance on Feb. 1, 2026. Today's total $1,2357 Monthly Payments of $288 each. Today's total $513 ($288 + Registration Fee)
Total

$0.00
Coupon Code:
Payment Info

Payment*

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

Should be Empty:

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Educate Your Child... Educate a Generation

Student Details

First Child

2nd Child

Third Child

Parent Details

Agreements

Tuition

Payment Info