Hebrew School Registration

Cteen Junior

At Chabad Hebrew School, we view Bar/Bat Mitzvah as a means to an end, not an end in itself. When a child turns Bar or Bat Mitzvah, it is the beginning of a lifetime journey into Judaism. We have therefore created a very unique curriculum for children pre/post Bar/Bat Mitzva, our goal being to foster awareness that this milestone is only the beginning of Jewish life, not the end, and to help our students attain a greater appreciation of the responsibilities of a Jewish adult.

Cteen Junior includes fascinating guest speakers, social action opportunities, meaningful trips, and thought provoking and relevant discussions, and more!

For students 7th-8th Grade.

Chabad of Holmdel Hebrew School recognizes what an exciting yet challenging time this is in your child’s life. We hope that our Pre/post Bar/Bat Mitzvah program will give your child the tools he/ she needs to properly navigate life as a responsible Jewish adult.

We look forward to working with your child during this exciting time of their lives!

We are currently accepting forms for the 2024-2025 school year.

Please fill out ALL fields of this form.

If you have any questions or concerns you'd like to discuss with us feel free to call our director Rochi Galperin at 732-772-1998 or email [email protected].

Student Full Name*

First Name Last Name

Hebrew Name*

First Name Last Name

Birth Date*

Month Day Year

Time of Birth *

Hour Minutes

School*

Grade entering*

Previous Jewish Education

Hebrew Reading Proficiency *

NoneSomewhatWell

Does your child have any learning disabilities? please specify *

Address*

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

Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.

Father's Name*

First Name Last Name

Father's Cell*

Area Code Phone Number

Mother's Name*

First Name Last Name

Mother's Hebrew Name

Mother's Cell*

Area Code Phone Number

Was the child's mother born Jewish?*

YesNo

Is the child's father Jewish?**

YesNo

Was the child's mother's mother born Jewish?*

YesNo

Are there any adoptions in the family?*

YesNo

Are there any conversions in the family?*

YesNo

If you answered yes to either one please specify:

Mother's E-mail*

Father's E-mail*

Emergency Contact Besides Parent*

First Name Last Name

Phone Number*

Area Code Phone Number

Pediatrician*

First Name Last Name

Phone Number*

Area Code Phone Number

Medication child is taking on a regular basis*

Any special medical circumstances or allergies*

I authorize Chabad Hebrew School to take my child on school trips. (you will be notified prior to any trips)

I authorize Chabad Hebrew School to take pictures/video of my child and use them for publicity purposes (i.e., Brochures, Websites)

In the event I cannot be reached, I hereby grant permission to the staff of Chabad Hebrew School to treat and/or provide a physician or hospital to give emergency treatment to my child.

*

I have read & agree to all the above.

Signature*

Date*

Month Day Year

No one will be turned away due to lack of funds. Please contact Rabbi Galperin for payment plans or scholarship requests 732-772-1998.

Payment in Full Upon Submission ($850 per child)

$850

Two instalments to be be paid upon form submission and January 1, 2025

$425$850

Payment*

Credit Card Check

Postal / Zip Code

Country

I would like to receive news and updates from Chabad Jewish Center of Holmdel by email. I understand that information I provide to Chabad Jewish Center of Holmdel will be used according to its Privacy Policy and I can unsubscribe at any time.

Cteen Junior Registration

Student Information

Parents Information

EMERGENCY INFORMATION

Payment