If you are a returning student at Weston Hebrew School, please click here.

Family Information
Family Name
Address City
Zip Code Home Phone
Father's Name Hebrew if Available
Address (if different) City
Zip Code Home Phone
Father's Email Father's Cell Phone
Mother's Name Hebrew if Available
Address (if different) City
Zip Code Home Phone
Mother's Email Mother's Cell Phone
Marital Status of Parents Does someone other than the parent(s) care for your child(ren)?
If yes, please give name Phone Number
The biological mother of the child is Jewish from birth Converted Not Jewish
(If there are any conversions in the family, please send us the conversion certificate.)
Child Information
1. Child's Name

Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family
2. Child's Name Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family
3. Child's Name Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family
4. Child's Name Hebrew Name
DOB Hebrew DOB (if not known, please indicate time of birth)
School Attending Grade Entering
Placement in Family
Please name/age siblings who are not being enrolled in the Hebrew School for the year 2015-16
Tuition & Payment
PROGRAM:
EARLY BIRD DISCOUNT: Full payment by May 30, 2015 entitles you to a 5% discount
Member Rate $625 Tuition + $100 Book Fee + $25 Program Fee $750
Non-Member Rate $875 Tuition + $100 Book Fee + $25 Program Fee $1,000
Total:
PAYMENT:
I wish to pay by: Check Credit/Debit Card
Please charge the full tuition amount to the following credit card:
Please charge 10 payments to the following credit card on the of the month, for the next 10 months.
Checks should be made payable to Chabad of Weston, and sent to the Chabad Jewish Center at 18501 Tequesta Trace Park Lane, Weston. A fee of $25 will be charged for a return check.
Card Holder Name Card Type
Credit Card Number CVV
Exp Date Total Paying Now
Enrollment Agreement
To enroll your child(ren) in Weston Hebrew School, all forms must be completed and sent in to the school. Your application will not be processed without the required forms and fees.
Full payment, or a payment plan must be set up by the beginning of the school year, September 1, 2015.
Enrollment is considered to be for the entire scholastic year. There will be no refunds even if the child is absent due to illness, holidays, vacations and snow days, or should the parents decide to withdraw the child from the program.
In the event that tuition is not paid, Weston Hebrew School reserves the right to debit your Credit/Debit card, plus a $25 processing fee
DISPOSITION
Parent acknowledges that Weston Hebrew School serves children who are able to function successfully in a group setting. If, in the judgment of the school's Director, the child is not able to function in a group setting, the parent may be asked to withdraw the child. In the event that the parent is request to withdraw the child, the Director will work with the parent to identify possible alternative programs suitable for the child.
RELEASE OF INFORMATION AND PHOTOGRAPHS
Parents allow for child(ren)'s picture to be used for internal PR mailing and website where name is not given. Parents allow for child(ren)'s photograph/name released to newspapers where last name will not be given. If not, please contact us.
By submitting and initialing this form, parents accept the terms outlined above.
Parent's Initials Date

Weston Hebrew School at Chabad of Weston