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Registration

Registration

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Register today to ensure a Jewish tomorrow. Please complete the form below. If you have any questions, feel free to contact our Hebrew School Director, Mrs. Mushkie Kesselman, who will be happy to discuss your child with you! 214.274.0752 or email Mushkie@chabadfrisco.org.

RE-REGISTRATION FOR PAST STUDENTS CAN BE FOUND HERE
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STUDENT REGISTRATION
CHILD 1
Child's name   Hebrew Name
Date of Birth / / M F

Grade Entering

Previous Hebrew School attended/years attended:
CHILD 2
Child's name   Hebrew Name
Date of Birth / / M
F

Grade Entering

Previous Hebrew School attended/years attended:

PARENT INFORMATION

Father Mother
Fathers Full Name Mothers Full Name
Hebrew Name Hebrew Name
Home No. Home No.
Work No. Work No.
Cell No. Cell No.
Email Email
Address City/State/Zip


Synagogue Affiliation

Marital Status: Married Divorced Single

Were there any conversions or adoptions in your family? Yes No
If yes, please explain:

 

EMERGENCY CONTACTS (Other than parents)

Name

Phone

Relationship to Child

 

MEDICAL QUESTIONAIRE

Does your child have allergies? (Food or medication)
Does your child take medication regularly? If yes, what kind?
Family Doctor's Name Phone
Medical Insurance Carrier Policy Number
Please list any special needs (physical, developmental, learning, emotional, behavioral) that may require special awareness on the part of our staff.
Does your child have an IEP? Yes No If yes, please submit.

 

DATES AND RATES

Dates: The 2017-2018 school year begins August 30, 2017 and ends May 23, 2018. Our calendar follows the Frisco ISD schedule for seasonal breaks and days off.

Registration Fees per family: $50

Deposit: A $150 deposit per child must accompany each registration. The deposit will be applied toward the registration fee and tuition.

Tuition Fee: Grades K-6th| $500/Year
 
PAYMENT OPTIONS

BY CHECK: Chabad of Frisco
Full tuition will be submitted (You may send post-dated checks)

Deposit Only (please provide credit card below and indicate when to have the balance charged)

BY CREDIT CARD:
Charge Full tuition

Charge deposit ($150) now (please indicate when to have the balance charged)

Spread my payments over the school year (August-April) and charge my card on the 1st of each month.

Please divide the balance into the following payments:

Date: / /
Amount:
Date: / /
Amount:
 
Charge Amnt.
Card Type
Visa M/C AMEX
Name on card
Card No.

Exp. Date

CVV Code
3 digits on back of card

Special Request for Financial Arrangements
Our financial chair will talk to you personally and a mutually agreed upon fee will be arranged. This will occur in a strictly confidential manner. No person or family will be turned away due to lack of funds.

If you have requested special financial arrangements, you will be charged the registration fee only now, and the balance will be charged after you have come to a financial agreement.

Please have the financial chair contact me regarding special financial arrangement.
Phone number where you can be reached:

Cancellation Policy: On or before August 15, 2017, 100% refund; after August 15, 2017, 30% refund.

(There is no refund for registration fee or daily absences)

 

PERMISSION FORM

I hereby give permission for my child to be transported to and from field trips, and to participate in them in all Hebrew School activities.
I understand that during the course of Hebrew School my child can be hurt. I accept the risk of possible injury and authorize any member of the Frisco Hebrew School staff to render any necessary first aid. Furthermore, in an emergency case, I hereby authorize Mushkie Kesselman or another staff member to have my child taken care of by a physcian or other medical person in any way the situation calls for.

Parent Signature: Date: / /

 
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