Registration for returning students

Student Information
Name*
First Name Last Name Hebrew Name
Date of Birth
Grade Entering
Please check all applicable*
- Medical information is same as last year
- Home address and phone / cell number are same
- Parental status and information are same
- Parental employment and contact info is same
- Emergency contacts and info is same
- I agree to the same disclaimer I signed last year for JYN Hebrew School
If any of the above is changed please specify below
Tuition Fees
$800.00 Tuition • Charitable tax receipts will be issued for the full amount of all tuition fees paid.

$75.00 Deposit • This is non-refundable and must be paid by credit card at the time of registration.
Payment Information
Save $50.00 - Early bird registration until May 15.
Please Choose Payment Plan
Please Choose Payment Method
(Due to credit card company fees, Visa & MC will be processed with an additional 3% surcharge)
Card Number
Name on Card
Expiration Date (mm/yy)
Security Code
Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Promo Discount Code
Disclaimer
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of JYN Hebrew School to hospitalize or secure treatment for my/our child, I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, JYN Hebrew School personnel will try, but are not required, to communicate with me/us prior to such treatment. I/we hereby give permission for my/our child to participate in all school activities, join in class and school trips on and beyond school properties and allow my/our child to be photographed while participating in Hebrew School activities. I/we also understand that all liability and costs resulting from damage to property and/or personal injury caused or attributable to my/our child/children will be my/our responsibility and I/we agree to fully indemnify and save JYN Hebrew School and it’s associates, teachers and agents harmless therefrom. I/we consent to JYN Hebrew School’s use of our personal information and of our child/children at its discretion in pursuit of school activities. Refund Policy: Before November 15 - 50% of tuition fees refund. Before December 15 - 25% of tuition fees refund. After December 15– No refund. There is no refund for daily/weekly absences. Please note that all cancellations must be made via email.
Parents
Mom*
First Name Last Name
Mom's Email*
Mom's Cell*
Dad*
First Name Last Name
Dad's Email*
Dad's Cell*
Digital Signature

Student Information

Tuition Fees

Payment Information

Disclaimer

Parents