Chabad Hebrew School of Tucson

Home Address*

Father's Name

First Name Last Name
Hebrew name
Phone Number
E-mail
Mother's Name

First Name Last Name
Hebrew name
Phone Number
E-mail
Which email to receive updates

FatherMotherBoth
Religious & Educational:
Previous Jewish Education*
Does your child have any learning difficulties with General Studies?**

YesNo
Does your child read basic Hebrew?*

NoneSomewhatWell
Are there any conversions and/or adoptions in the family or grandparents?*

NoYes
If yes, please elaborate.*
Medical Information:
Is there any special medical or other information that we should be aware of?*
Does your child have any allergies*
Emergency Contact (if parent listed above, just write name)*
Phone Number*
Medical Release*

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

Pay in full - Complete Year - $850Pay per session - $300Sibling discount - Pay in full -Complete year -$800Monthly Ckids Club- $240

Payment

Credit Card Check

Postal / Zip Code

Country

Total

$0.00
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Programs

Student Information