Returning Students Registration Form

Returning Students Registration Form
For returning students, please complete the brief registration form below to apply for the 2024-25 school year. (A New Student Registration Form must be completed for any siblings joining our program for the first time.)

We look forward to providing your children with an outstanding Jewish education!
How many children are you registering today?*
Child 1 Name*
First Name Last Name
Grade Entering*
Child 2 Name
First Name Last Name
Grade Entering
Child 3 Name
First Name Last Name
Grade Entering
Primary E-mail Address for Parent Communications*
Tuition Agreement

2 years - 5 years old: $200
6 years to 11 years old: $450
Sibling Discount: $50
Please select one of the following payment options*

Full tuition paymentPlease contact me to discuss scholarship opportunities
Payment Method*

Please charge my card belowPlease charge my card on fileI will send a check/s

Payment

Credit Card

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

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Medical Release Form
I hereby give consent to the administration of Chabad of Sierra Vista to take whatever medical measures they deem necessary, at my expense, for my child in the event of a medical emergency.
*

I accept
Full Name*
First Name Last Name
Date*

Month Day Year
Should be Empty:

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