Please fill out this form as an initial registration for JUDA

Confirmation of acceptance will be acknowledged after this registration form is reviewed.

 

Student Information 

Full Name:     

Birthday:     Gender: 

I would like to register my child for: Sunday's in Blue Ash  Tuesday's on Hyde Park

Family Information

Home Address:  

                            

Home Phone Number: 

Father:   

               

              

Mother:  

               

              

Which email would you like used for updates and newsletters?  Mother Father Both

 

Religious & Educational:  

What school does your child attend?  Grade entering:  

 

Does your child have previous Jewish Education Yes No 

If yes, please describe: 

Does your child read basic Hebrew?  None  Somewhat Well 

Does your child speak/understand Hebrew?  None  Somewhat Well 

Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential): 

Is the natural mother of the child Jewish? Yes No 

Is the natural grandmother of the child Jewish? Yes No  

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

 

Medical & Emergency Information 

Is there any special medical or other information that we should be aware of? Yes No 
If yes, please describe: 

 

Does your child have any allergies? Yes No 
If yes, please describe: 

 

Is your child currently taking any medication?  Yes No

If yes, please describe:
 

 

Emergency Contact #1:   

Emergency Contact #2:    

 I hereby give consent to the administration of the Chabad Hebrew School of the Arts to take whatever medical measures they deem necessary, at my expense, for my child in the event of a medical emergency.

 I hereby give permission to my child to participate in all school outings and field trips beyond school properties and to use any transportation selected by the Chabad Hebrew School.

 

Tuition Agreement

The following is a tuition agreement for the JUDA. The agreement explains the tuition fees, payments plans and refund policies. Please read it through carefully. If paying by check or cash, full payment must be submitted to the school office before any child will be permitted to attend classes. 

The tuition for the JUDA is $520.00 per year per child (this includes a registration & book fee). Ages 3-5 are half price: $260.00


Discounts: There is a 10% discount off of the regular tuition for each additional child of the same family. There is a 10% additional discount off your total tuition for each child of another family you successfully introduce to the JUDA. 

 You may choose from the following payment methods: 
PLAN A: You may pay the entire amount in full with a check, cash or credit card. 

PLAN B: You may pay the annual tuition on a monthly basis by submitting 1 check now (or credit card payment) in the amount of $50 (deposit) and 10 checks of $47.00 each, dated September through June. All checks must be submitted before the first day of JUDA. (Ages 3-5 10 checks of $26.00 each) 

PLAN C: You may use your credit card to pay the tuition on a monthly basis. Your credit card will be billed $50 for deposit now and $47.00 ($26 for ages 3-5) September through June. To do so, please include your billing information at the bottom of this page. 

I understand that refunds for children withdrawing from school before the end of the school year will be pro-rated up to February 1 provided that the school office is given 30 days written notice and does not include a $50 registration and book fee. Tuition refunds will not be granted to children withdrawing from school after February 1. There are no refunds or credits for days missed due to illness, holidays, or family vacations.  

 

Payment Information: 

Credit Card Number    CVV: 

Name on Card: Exp. (mm/yyy)  

Billing address (if different from Home Address):