Student's Information
Child's First Name:
Child's Last Name:
Child's Hebrew Name (if known):
Gender:
Child's DOB(MM/DD/YYYY):
Age as of September:
Grade entering in September:
School Name:
Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.
CLICK THE PLUS SIGN TO ADD ANOTHER CHILD'S INFORMATION.
Yes
No
Child's Home Address:
City:
State:
Zip Code:
Emergency Contact Number (if different than parents):
Emergency Contact Name:
Relationship to Child:
Parent's 1 Information
Parent 1 First Name
Parent 1 Last Name
Parent 1 Phone
Parent 1 Email
I would like to receive news and updates by email
Parent's 2 Information
Parent 2 First Name
Parent 2 Last Name
Parent 2 Phone
Parent 2 Email
Parent's Marital Status
Mother's Religion:
Father's Religion:
Kindly check the schedule options:
Sundays, 10:00 AM
Wednesdays, 4:00 PM
2026-2027 Annual Tuition Pricing: Early Bird: $1,050 Tuition when you register by August 25th (includes workbooks) Regular Tuition: $1,200 per child when you register after August 25th (includes workbooks) *IMPORTANT TO NOTE: Tuition may be paid out in 4 installments
Payment Information
Recurring option
One time payment
4 Months installment
Payment Method
Sponsor a Jewish child who cannot afford JUDA Hebrew School:
Amount
Total Amount
0.00
Credit Card Information
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Expiration
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Address
Zip
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