Registration Form

The 2023-2024 Hebrew School year begins September 10, 2023 and ends May 19, 2024.

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. Esther Horowitz, to discuss them! Call 972-596-8270 or click here to email.
Section 1. Parent's Infomation
Parent 1
Name*

First Name Last Name
Cell*

Area Code Phone Number
Email*

Mailing Address*

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

Hebrew Name
Home Number

Area Code Phone Number
Parent 2
Name

First Name Last Name
Cell

Area Code Phone Number
E-mail

Mailing Address (if different than above)

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

Hebrew Name
Home Number

Area Code Phone Number
Marital Status

MarriedDivorced
Synagogue Affiliation
Amount of children to register*
Were the child(ren), mother and maternal grandmother all born Jewish?*

YesNo, (Please explain below)
Conversion or adoption information
Section 2. Child's Information
Child's Name*

First Name Last Name
Grade Entering*
Birth Date*

Month Day Year
Hebrew Name
Child 2
Child's Name

First Name Last Name
Grade Entering
Birth Date

Month Day Year
Hebrew Name
Child 3
Child's Name

First Name Last Name
Grade Entering
Birth Date

Month Day Year
Hebrew Name
3. Emergency Information
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relationship to Child
Does your child have allergies? (Food or medication)*

NoYes, (Please List Below)
Allergies:
Does your child take medication regularly?*

NoYes, (please explain below)
Medication Info:
Any special needs (physical, developmental, learning, emotional, behavioral) that may require special awareness on the part of our staff.*

N/AYes, (Please list below)
Special needs:
Does your child have an IEP? *

NoYes
4. Dates and Rates

Dates: The 2023-2024 school year begins September 10, 2023 and ends May 19, 2024. Our calendar follows the Plano ISD schedule for seasonal breaks and weekends off.

Rates: Registration Fees per child: $50 (Registration Fees are not refundable)

Security Fee:
Due to heightened security concerns we plan to have a security guard on premises whenever school in in session. To help defray the costs we will charge each family a one time security fee of $60/family

.	Grade	Early bird - on or before August 28, 2023	After August 28, 2023
Tuition Fees	Kindergarten - 7th grade	$945	$995
Discounted Tuition for Members	Kindergarten - 7th grade	$795	$845

5. Payment Options
How would like to set up your payments*

Charge registration fee and full tuition now (you will see two separate charges on your credit card bill reflecting the registration fee and tuition)Charge registration fee now, and spread my tuition payments over the school year (September-May) and charge my card on the 1st of each month.Charge registration fee now, and divide the balance into 2 equal payments on September 12, 2023 and January 9, 2024Charge the registration fee and please have the financial chair contact me regarding special financial arrangement
Please tick your rate box*

Regular subsidized rate: $945 early bird / $995 after August 28, 2023Regular non-subsidized rate: $1,200Chabad of Plano member rate: $795 early bird / $845 after August 28, 2023
Dates
Amounts
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.

All arrangements must be taken care of by September 12, 2023.

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.
Phone Number where you can be reached

Area Code Phone Number
Registration fee amount be charged today

$0.00

Payment

Credit Card Other

Postal / Zip Code

Country

Cancellation Policy: On or before September 12, 2023, 100% refund; after September 12, 2023 50% refund.
(There is no refund for registration fee or daily absences)
6. Permission Form
I hereby give permission for my child to be transported to and from field trips, and to participate in them and 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 Chabad of Plano Hebrew School staff to render any necessary first aid. Furthermore, in an emergency case, I hereby authorize Esther Horowitz 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's Signature*
Date

Month Day Year
If you are interested in becoming a member of Chabad of Plano, please call the office at 972.596.8270. and ask for a membership package to be mailed to you.
Comments / Questions
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Programs

Registration Form

Section 1. Parent's Infomation

Parent 1

Parent 2

Section 2. Child's Information

Child 2

Child 3

3. Emergency Information

4. Dates and Rates

5. Payment Options

6. Permission Form

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