Returning Student Register - JewishGilbert.com

GILBERT HEBREW SCHOOL RE-REGISTRATION (RETURNING STUDENTS)
2024-2025 School Year
Child's Name*
First Name Last Name
Hebrew Name
Birth Date*

Month Day Year
Grade entering*
School*
Father's Name*
First Name Last Name
Father Cell*
Father E-mail*
Mother's Name*
First Name Last Name
Mother Cell*
Mother E-mail*
Does your child have any learning difficulties with general studies or do they have an IEP?*
If yes, please describe
Medical Information
Up to Date with Vaccinations?*

YesNo
Are there any special medical, allergy or other information that I should be aware of?
Emergency Contact*
First Name Last Name
Phone Number*
Relation to Student*
City/Town*
Family Physician*
Phone Number*
Accident, Trip & Privacy Declaration:

Accident: As the parent or legal guardian of the above listed child, I authorize any adult acting on behalf of Gilbert Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Gilbert Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment.

Trips & Outings: I hereby give permission for my child to attend and participate in all trips and outings organized as part of the program by Gilbert Hebrew School.

Privacy: I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Gilbert Hebrew website or for promotion of our program. I give permission for our family contact information to be shared with other families.
Authorization*

Click to confirm consent
Parent Signature*
Payment
2024-2025 Hebrew School Tuition - $650: Tuition fees include all books, art materials and trips. Synagogue membership is not required. Affiliated and non-affiliated are welcome.

Security Guard Fee - $140

A $100 non-refundable deposit per child is due with registration. The deposit will be applied to tuition.

$25 Early Bird Discount for registration received by July 1, 2024. 10% discount for additional children in same family.
Payment Plans*

Plan A: Pay full Tuition by September 1st, which entitles a $30 discount off the family's total tuition fees.Plan B: Automatically charge credit card on the first of each month, September – May
Request for Scholarship

Due to the needs and limits of our family, we would like to request a scholarship. Scholarship requests will be reviewed and responded to within 3 weeks of submission.
Scholarship Amount:
Amount we are prepared to pay towards our child’s Hebrew school tuition
Tuition Deposit*

$100.00
Additional Payment Toward Tuition to be paid upon submission of form.

$
Total

$0.00

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

Should be Empty:

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GILBERT HEBREW SCHOOL RE-REGISTRATION (RETURNING STUDENTS)

2024-2025 School Year

Medical Information

Payment