Hebrew School Registration 2.0

How many students are you registering?

1 Student

2 Students

3 Students

4 Students

Student Information

Student Number 1

Full Name

Hebrew Name

Birth Date

School

Grade entering

Hebrew Reading Proficiency

Previous Jewish Education

Yes

Address

City

State & Zip Code

Additional Notable Information

Please let us know if there are any allergies or other important information we need to be aware of.

Student Number 2

Full Name

Hebrew Name

Birth Date

School

Grade Entering

Hebrew Reading Proficiency

Previous Jewish Education

Yes

Address

City

State & Zip Code

Additional Notable Information

Please let us know if there are any allergies or other important information we need to be aware of.

Student Number 3

Full Name

Hebrew Name

Birth Date

School

Grade entering

Hebrew Reading Proficiency

Previous Jewish Education

Yes

Address

City

State & Zip Code

Additional Notable Information

Please let us know if there are any allergies or other important information we need to be aware of.

Student Number 4

Full Name

Hebrew Name

Birth Date

School

Grade entering

Hebrew Reading Proficiency

Previous Jewish Education

Yes

Address

City

State & Zip Code

Additional Notable Information

Please let us know if there are any allergies or other important information we need to be aware of.

Parents Information

Father's Name

Father's Email

Father's Cell

Mother's Name

Mother's Cell

Mother's Email

Mother's Hebrew Name

Mother Jewish by:

Best way to send Hebrew School updates:

I am willing to assist in school activities, please contact me.

Medical Information

Emergency Contact 1

Phone Number

Emergency Contact 2

Phone Number

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.

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of MV 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, MV 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 MV Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept

Registration

Tuition Schedule Hebrew School Track

Sunday mornings 9:30-11:30am

Tuition - $1,050 (yearly)

Program & Tuition Agreement

I hereby confirm my child’s enrollment in Merrimack Valley Hebrew School. I represent that I am the custodial parent or legal guardian of the child that I am enrolling and that the information I have provided is true and correct. I agree to Merrimack Valley Hebrew School's terms and conditions as outlined in the Parent Handbook. I fully understand that this enrollment, as part of my commitment to a long-term Jewish education at Merrimack Valley Hebrew School, is accepted only on the basis of the full year program, and agree to pay the full annual or Monthly fees accordingly. I understand that no refunds or adjustments will be made for absences including, but not limited to, illness or vacation. I fully understand that by choosing monthly payment, Merrimack Valley Hebrew School will charge my card automatically every month (upon acceptance).

How do i want to pay? (2 kids) Tuition Fees cover all weekly activities, snacks, and drinks

Total Amount

0.00

Payment Method

Credit Card Information

Type

Number

Expiration

Code

Use contact info above

Name

Address

Zip

I (WE) HEREBY ENROLL OUR CHILD IN THE MERRIMACK VALLEY HEBREW SCHOOL OF MERRIMACK VALLEY. IN THE EVENT OF A MEDICAL EMERGENCY AND NEITHER PARENT CAN BE REACHED, MEDICAL TREATMENT MAY BE PROVIDED AS NECESSARY. I HEREBY GIVE PERMISSION FOR MY (OUR) CHILD/REN TO PARTICIPATE IN ALL HEBREW SCHOOL ACTIVITES, JOIN IN CLASS AND SCHOOL TRIPS ON AND BEYOND SCHOOL PROPERTIES. MY (OUR) CHILD MAY BE PHOTOGRAPHED AND THE PICTURES MAY BE USED FOR PUBLICATION BY MERRIMACK VALLEY HEBREW SCHOOL.

Signature

I would like to receive news and updates by email

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