3 Track Options 1. In Person on Sundays 10:00 AM - 12:00 PM at Chabad- small class sizes - following government guidlines. 2. At Home "Out of the Box " Hebrew School - Sundays 9:45 AM - 11:30 AM virtual class with live teachers - All supplies & materials provided. 3. " Pod Classes" - small groups in private homes, once a week - you provide the kids, we provide the rest. Day & Time based on family prefrence. 4. Bar Mitzvah Classes - Boys grade 6-8 - Day & Time To Be Decided 5. Bat Mitzvah Classes - Girls grade 6-8 - Tuesdays 6:00 - 7:30 PM at Chabad Child 1 Child Full Name First Name Last Name Hebrew Name Birth Date 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year School Attending Grade Entering Was the natural mother born Jewish? Yes No Were there any conversions in the family? Yes No If yes - who was the Rabbi? Temple / Synagogue affiliation (if applicable) Registration Options We have lowered our tution this year with the understanding of the financial challenges during these times. Sunday Mornings at Chabad - $450 " Out of the Box" Virtual Classes - $300 + $50 required supply fee "Pod Classes" - $450 "Bat Mitzvah Club" - Tuesdays from 6:00 - 7:30 $450 "Bar Mitzvah Club" - Day TBA - $450 As always there is NO COST for our Kindergarten program. Payment Plans Available! No one will be turned away due to lack of funds. Once completing your registration form please contact Hadassah Geisinsky to complete your registration! We understand that circumstances may change throughout the year and you will be able to change tracks at any time. Kindergarten - Sunday Morning at Chabad Hebrew School Grades 1-8 Sunday Morning at Chabad Hebrew School Kindergarten - "Out of the Box" Virtual Classes Grades 1-8 "Out of the Box" Virtual Classes Kindergarten "Pod Class" Hebrew School Grades 1-8 "Pod Class" Hebrew School Girls Grade 6-8 Tuesday Night Bat Mitzvah Club Boys Grade 6-8 Bar Mitzvah Club Please speciy any medical or behavioral concerns that we should be aware of: Child #2 If Applicable Full Name First Name Last Name Hebrew Name School Grade Birth Date 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Registration Options We have lowered our tution this year with the understanding of the financial challenges during these times. Sunday Mornings at Chabad - $450 "Out of the Box" Virtual Classes - $300 + $50 required supply fee "Pod Classes" - $450 "Bat Mitzvah Club" - Tuesdays - 7:00 - 8:30 - $450 "Bar Mitzvah Club" - Day TBA - $450 As always there is NO COST for our Kindergarten program. We understand that circumstances may change throughout the year and you will be able to change tracks at any time. Child #2 Registration Options Kindergarten - Sunday Morning at Chabad Hebrew School Grades 1-8 Sunday Morning at Chabad Hebrew School Kindergarten - "Out of the Box" Virtual Classes Grades 1-8 "Out of the Box" Virtual Classes Kindergarten "Pod Class" Hebrew School Grades 1-8 "Pod Class" Hebrew School Girls Grade 6-8 Bat Mitzvah Ciub - Tuesday Night Boys Grade 6-8 Bar Mitzvah Club Please speciy any medical or behavioral concerns that we should be aware of: Parent Information Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Phone Number Area Code Phone Number E-mail Father Name First Name Last Name Father Cell Phone Number Area Code Phone Number Father Email Mothers Name First Name Last Name Mother Cell Phone Number Area Code Phone Number Mother Email Mother born jewish Yes No Emergency Information Full Name First Name Last Name Phone Number Area Code Phone Number Relationship 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 As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad of the Five Towns 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 of the Five Towns Hebre School. Agree Initials Payment There is a 10% Sibling discount that we will apply once your form has been submitted. There is a 20% refer a family discount - please contact Hadassah if you have refered a new family to apply this discount No one will be turned away due to lack of funds - once submitting your form please contact Hadassah Geisinsky - 516-458-3694 to finalize your registration Payment Credit Card Other Credit Card Visa MasterCard American Express Discover Credit Card Type Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 Expiration Year Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Total $0.00 I would like to pay today: Full amount $0.00 minimum $ Yes, I'd like to donate the cost of processing this transaction by adding 3% Disclaimer Accident: As the parent(s) or legal guardian of the above child/ren, I/we authorize any adult acting on behalf of Chabad Five Towns 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 Five Towns Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. Privacy: I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Chabad Five Towns website or for promotion of our program. Digital Signature of Parent or Legal Guardian First Name Last Name Month Day Year Submit Should be Empty: This page uses TLS encryption to keep your data secure.