Returning Student Registration

We are excited for a new year at Chabad Hebrew School of Vernon Hills.

This form is for returning students.

A separate New Student Registration Form must be filled out for any siblings joining for the first time.

We look forward to another wonderful year of learning and growth with your family!
How many children are you registering as returning students? *
Student Information - Child 1
Full Name:*
First Name Last Name
Current Age:*
Date of birth:*

Month Day Year
Grade Entering:*
Does this student have any allergies?*

YesNo
If yes, please list them:*
Does this student have an IEP?*

YesNo
If yes, please explain:*
Child 2
Full Name:*
First Name Last Name
Current Age:*
Date of birth:*

Month Day Year
Grade Entering:*
Does this student have any allergies?*

YesNo
If yes, please list them:*
Does this student have an IEP?*

YesNo
If yes, please explain:*
Child 3
Full Name:*
First Name Last Name
Current Age:*
Date of birth:*

Month Day Year
Grade Entering:*
Does this student have any allergies?*

YesNo
If yes, please list them:*
Does this student have an IEP?*

YesNo
If yes, please explain:*
Parent Information
Father's Name:*
First Name Last Name
Father’s Email:*
Father’s cell:*
Mother's Name:*
First Name Last Name
Mother's Email:*
Mother's Cell:*
What school does your child attend?*
What are your child’s special interests, likes or dislikes?*
Other Information
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of the 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, the 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 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 the Chabad Hebrew School activities and that these pictures may be used for marketing purposes.*

I accept
Name and Initials:*
Name: Initials:
Tuition
Your application will be complete with a payment plan.
Complete Year, Ages 5-13 - $1,050
Early Bird Discount $995 until August 1
Includes: Books, Supplies and Snack Fee
Register today to apply the 10% off discount for returning families.
Please consider sponsoring a Jewish holiday program at Chabad Hebrew School to bring the Jewish holidays to life for our students.

Rosh Hashana Fun DaySukkot ExperienceChanukah CelebrationPurim FestivitiesPassover ExperienceShavuot Sundaes
Amount Sponsored: The sponsorship will be added to the total cost of tuition. We appreciate your support

$
Optional: I'm aware that there are students on scholarship. I'd like to contribute this additional amount towards the tuition of a fellow student in need.

$
Total:

$0.00
Please select your payment plan:*

Pay in full (charged October)5 monthly payments (starting October, charged monthly)Two installments (charged October 1 and Jan 1)

Payment:*

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Educate Your Child... Educate a Generation

Student Information - Child 1

Child 2

Child 3

Parent Information

Other Information

Tuition