Registration 2024-25

FREE HEBREW REGISTRATION 2024-25

Please fill out 1 form per child.

Please note registration fees are non refundable.

To re-register an existing child, click here

To register for Merton Pelo Program, click here

Registration Options*

Sunday School -10:00am-12:30pm (Or Shalom- 96 Fredmir St., DDO) $229/$219 (second child) all gradesLunch Program on Thursdays $89 - If selected please choose the school belowLunch Program Thursdays @ Friendship Circle 12pm-12:45pm- $89After School Program $229/$219 (second child) - If selected please choose the school belowTuesdays @ Or Shalom in DDO $229/$219 (second child) 4:15PM-5:30PM

Which School for Lunch Program?

Which School for After School Program?

Full Name*

First Name Last Name

Hebrew Name*

Birth Date*

Month Day Year

Time Born* In Judaism the day begins at nightfall, so the exact Jewish birthday will depend on the birth being before or after sunset.

Before SunsetAfter Sunset

School Attending*

Grade Entering as of Sept 2024*

Previous Jewish Education*

YesNo

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.*

Father's Name*

Father's Cell #*

Father's Email Address*

Father's Business Name

Father's Position

Father's Business Address

Mother's Name*

Mother's Hebrew Name*

Mother's Cell #*

Mother's Email Address*

Mother's Business Name

Mother's Position

Mother's Business Address

What is your instagram account? So we can tag you in pictures

I'd like to be part of the Free Hebrew Parents Committee!

YESNO

Home Address*

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

Parent's Status*

Language Spoken at Home

Congregation Affiliation*

Emergency Contact 1*

Phone #1*

Emergency Contact 2*

Phone #2*

Medicare Card #*

Name

Birthdate

School Attending

Name

Birthdate

School Attending

Amount Paying for Sunday School*

$229$219

Amount Paying for After School Program*

$229$219

Amount Paying for TUESDAY After School Program*

$229$219

Amount Paying for Lunch Program*

$89

Amount Paying for THURSDAYS @ Friendship Circle Lunch Program*

$89

Total

$89.00

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

Email Address to send confirmation of Registration:

E-mail Address*

In order to ensure that every child gets picked up safely, please fill in the following information:

Does your child walk home by him/herself?*

YesNo

Does your child go to late class?*

YesNo

If not, who picks him/her up?*

What is this person's relation to the child?*

Any Additional information we should be aware of:*

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Free Hebrew for Juniors 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, Free Hebrew for Juniors personnel will try, but are not required, to communicate with me prior to such treatment.

I accept*

YESNO

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 Free Hebrew activities and that these pictures may be used for marketing purposes. I agree not to register my child(ren) in any other program (i.e. hockey, swimming etc.) during the same hours as Hebrew school.

I accept*

YESNO

Registration is not complete until you hear back from us by email or phone.

All new students are accepted on a trial basis.

I would like to receive news and updates by email

STUDENT

PARENT INFORMATION

EMERGENCY INFORMATION

BROTHERS & SISTERS

PAYMENT

PICK UP INFORMATION

AFTER SCHOOL, LUNCH PROGRAM & SUNDAY SCHOOL

KIDS MAKE SHABBAT

LAYLA TOV & BIRTHDAY CLUB

C TEEN PROGRAM

BAR & BAT MITZVAH CLUB

WOMEN'S CIRCLE