Register Online

We are currently accepting application forms for the 2025-2026 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

If you would prefer to fill out this paper and mail it into our office, you can print a PDF Printer Friendly Form.

Please submit a separate form for each child.

We look forward to a wonderful year of learning and growth.

Student Profile
First Name
Last Name
Hebrew Name
Email Address
Gender
DOB
School
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Hebrew Language
Proficiency 		None Somewhat Well
Previous Jewish Education Yes No
Where?
Learning Difficulties Yes No
  If yes, please describe:

Photo & Video Consent
I give permission for my child’s photo and/or video to be taken during Hebrew School activities and used for promotional purposes, including on our website, newsletters, and social media.

  Yes, I consent       No, I do not consent
Parent Information
Father's Information
First Name
Hebrew Name
Work Phone #
Cell Phone #
Email Address
Mother's Information  
First Name
Hebrew Name
Work Phone #
Cell Phone #
Email Address
Family Information  
Last Name
Address
Postal Code
Home Phone #
Fax #
Family History  
Is Child's Father Jewish? Yes No
Is Child's Mother Jewish? Yes No
Are there any conversions in the family? Yes No
If YES please copy and attach conversion documents
Are there any adoptions in the family? Yes No
Is anyone in your family a "Kohen" or a "Levi"? Yes No
  If yes, please explain:

Is the family a member of a Synagogue?

Yes No
  If yes, please specify:
Emergency / Medical Information
Emergency Information

In case of illness or injury of a child at school, every effort will be made to contact the parent or guardian. If parent can not be reached please contact:
Emergency Contact 1
Name
Phone
Cell Phone
Relationship
Emergency Contact 2
Name
Phone
Cell Phone
Relationship
   
Medical Information  
Family physician Name
  Phone

Insurance provider

Insurance ID #

Does your child have any allergies or other medical condition we should be aware of? Yes No
If yes, please describe them and indicate special precautions or care needed.
Is your child up to date with vaccinations? Yes No
Medical Release
I hereby consent to the administration of Chabad of Bay Ridge Hebrew School to take whatever medical measures they deem necessary for my child in the event of a medical emergency.

I Agree
Payment/Tuition Information

Payment Information

Tuition is a sliding scale ($720, $620 or $500)
Please indicate which plan works best for you and/or if you would like to place a deposit now and be billed at a later date. Our goal is to make Jewish experiences as accessible as possible. If you need further financial assistance, please do not hesitate to reach out to us.
Pay Now Full Tuition
(including deposit)
  $720
Pay Now Discounted Rate
(including deposit)
  $620
Pay Now Scholarship Rate
(including deposit)
  $500
Total Amount
Payment Plan Please arrange payment so that we can process your submission.  Payment Form

Tuition Information
Price

(Snacks & Drinks Included)

Receive a 10% discount for each additional Sibling
Scholarships are Available
I would like to request an additional Scholarship
 Yes         No 
I would like to work out a Payment Plan
 Yes         No 
 
If you would like to receive an  Email confirmation please confirm your email address:
 

We look forward to a wonderful year of learning and growth!