Virtual Hebrew School Registration Form

Child Information

Number of children you would like to register

Child's Name

Child's Hebrew Name

Child's DOB

Child's Hebrew DOB (if not known, please indicate time of birth)

Child's Current School

Grade Entering

Please tell us about your child, strengths, weaknesses, disposition and anything else that will help us best serve your child.

Second Child's Name

Second Child's Hebrew Name

Second Child's DOB

Second Child's Hebrew DOB (if not known, please indicate time of birth)

Second Child's Current School

Grade Entering

Please tell us about your child, strengths, weaknesses, disposition and anything else that will help us best serve your child.

Third Child's Name

Third Child's Hebrew Name

Third Child's DOB

Third Child's Hebrew DOB (if not known, please indicate time of birth)

Third Child's Current School

Grade Entering

Please tell us about your child, strengths, weaknesses, disposition and anything else that will help us best serve your child.

Fourth Child's Name

Fourth Child's Hebrew Name

Fourth Child's DOB

Fourth Child's Hebrew DOB (if not known, please indicate time of birth)

Fourth Child's Current School

Grade Entering

Please tell us about your child, strengths, weaknesses, disposition and anything else that will help us best serve your child.

Tuition & Payment

Tuition costs $700 per child.

Total Tuition $:

How would you like to pay?

Credit CardMail Check(s) to 730 Ponce de Leon Place NE, Atlanta, GA 30306

Name on Card

Card Number

Code

To enroll your child(ren) in Intown 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 the first payment in the case of a payment plan, is due at the beginning of the school year, September 1, 2020. 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, IHS reserves the right to debit your Credit/Debit card, plus a $25 processing fee.

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.PRIVACY RELEASE: I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Intown Hebrew School website or for promotion of our program.DISPOSITION: Parent acknowledges that Intown 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.

By submitting and initialing this form, parents accept the terms outlined above. Both parents must initial.

Mother's Initials

Date

Father's Initials

Date

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Virtual Hebrew School Registration Form

Virtual Hebrew School Registration Form

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