Hebrew School Registration

Parent's Info
Mother's Name*
First Name Last Name
Father's Name
First Name Last Name

Home Address*

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

Both parents reside at this address.Mother's AddressFather's Address

Father's Address

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

Mother's Address

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

Mother's Contact Info
Mobile Number*
E-mail*
Father's Contact Info
Mobile Number*
E-mail*
Children's Info
1st Child
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
My child has allergies.
Explain:
Do you have another child to enroll?

YesNo
2nd Child
Full Name
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date

Month Day Year
My child has allergies.
Explain:
Do you have another child to enroll?

YesNo
3rd Child
Full Name
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date

Month Day Year
My child has allergies.
Explain:
Emergency Contacts
In case of injury of a child, every effort will be made to contact the parent or guardian. If they are not available, the Emergency contacts will be reached out to.
Primary Contact
Full Name
First Name Last Name
Phone Number
Relationship to Child
Secondary Contact
Full Name
First Name Last Name
Phone Number
Relationship to Child
Family Info
Is the maternal grandmother of all the children Jewish?

YesNo
Are there any conversions in the family?

YesNo
Which relatives completed conversion?

MotherFatherGrandmotherGrandfather
Upload all conversion certificates:
You can also email them to [email protected]
Tuition
Tuition is $720 per child.

Your tuition total comes out to $720.00.
Payment Options*

Pay the total of $720 today.Pay $80 today and set up 8 recurring payments of $80 per month.
Tuition for the first child is $720.00.
Tuition for the second child is $630.00.

Your tuition total comes out to $1,350.00
Payment Options* 10% OFF for 2nd Child

Pay the total of $1,350 today.Pay $150 today and set up 8 recurring payments of $150 per month.
Tuition for the first child is $720.00.
Tuition for the second child is $630.00.
Tuition for the third child is $540.00.

Your tuition total comes out to $1,890.00.
Payment Options*

Pay the total of $1,890 today.Pay $210 today and set up 8 recurring payments of $210 per month.
Billing Information
If you are making monthly payments, please check the box below.
Yes, I'd like to make this a monthly recurring payment.
Payment Method

Credit CardCheck
After completing this form, checks can be mailed to Chabad of La Cantera: 15511 Oak Grove Drive S. Antonio, TX 78255.

If you are paying monthly, please send all 9 postdated checks.

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Total to be Charged Today:

$0.00
Should be Empty:

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Programs

Parent's Info

Children's Info

Emergency Contacts

Primary Contact

Secondary Contact

Family Info

Tuition

Billing Information

If you are making monthly payments, please check the box below.

Campus Activities