Registration - Chabad of Surprise

Child's Information
How many children are you enrolling?
Child’s Full Name*
Date of Birth*

Month Day Year
Grade Entering & School*
Allergies / Medical Concerns
Child's 2 Full Name*
Date of Birth*

Month Day Year
Grade Entering & School*
Allergies / Medical Concerns
Child's 3 Full Name*
Date of Birth*

Month Day Year
Grade Entering & School*
Allergies / Medical Concerns
Parent Information
Mother Full Name*
First Name Last Name
E-mail*
Phone Number*
Jewish?*
Father Full Name
First Name Last Name
E-mail
Phone Number
Jewish?
Parents' Marital Status

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Emergency Contact
Full Name*
First Name Last Name
Phone Number*
Relationship to Child*
Payment
Tuition for Hebrew School of the Arts (HSA) is $650 per child for the full year ($75/month), which includes free access to all Family Sunday events. We’re happy to offer a 10% discount for each additional sibling enrolled.

There is a $25, Regestration fee Per Family.

Once your child’s registration is reviewed and accepted, we will contact you directly to finalize details and arrange payment.

Payment Options:
• Pay in full: $700 (Early Bird: $650, end July 31st)
• 4 payments: $175 due in September, October, November, and December
• Monthly Payment: $80 (9 Payments)

We are committed to making Hebrew School accessible to every child. While we are proud to offer scholarships for families in need, we kindly ask that this option be reserved for those who truly require financial assistance. Your thoughtful consideration helps us allocate resources responsibly and support every family who needs it. No child will be turned away due to lack of funds.
Would you like to help sponsor a child’s HSA experience?

YesX
Thank you so much for your generosity!
We truly appreciate your willingness to help make HSA accessible for every child. We will be in touch with you directly to discuss sponsorship options and how your support can make the biggest impact.
Requesting financial assistance

YesNo need
If yes, please share a bit about your need and let us know what amount would be manageable for your family.*
Registration fee*

$25

Payment*

Credit Card Cash/Zelle

Comments
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Child's Information

Parent Information

Emergency Contact

Payment