Ready for Another Amazing Year?

We are thrilled you have decided to entrust us with your child's Jewish education.
We look forward to another fantastic year!

Registration includes:
- Hands-on activities & learning, Sundays 10am-12pm
- Welcoming community & friendships
- Registration to all Chabad Youth events for the duration of the school year

Ready to dive into CTeen or start your Bar/Bat Mitzvah journey? Tap below to join the fun!

PARENT INFORMATION

Your Name* Parent Submitting

First Name Last Name

E-mail*

Please indicate any change in address, email or phone #s from last year

How many children are you registering?*

up to 3

STUDENT INFORMATION

Child 1 Full Name*

First Name Last Name

Hebrew name*

School attending*

Grade entering*

Please indicate*

Current StudentNew Student

Child 2 Full Name*

First Name Last Name

Hebrew Name*

Date of Birth*

Month Day Year

Gender*

BoyGirl

School*

Grade entering*

Previous Jewish Education*

YesNo

Where?*

Please indicate*

Current StudentNew Student

Child 3 Full Name*

First Name Last Name

Hebrew Name*

Date of Birth*

Month Day Year

Gender

BoyGirl

School*

Grade Entering*

Previous Jewish Education*

YesNo

Where?*

Do/Does your child(ren) have any allergies or special medical considerations?*

YesNo

Please describe them and indicate special precautions or care needed.* Indicate names if submitting for multiple children

Do/Does your child(ren) have an IEP or receive any behavioral or educational support in school? (Sharing this information with us enables us to create a Hebrew School environment in which your child(ren) can thrive)*

YesNo

Please explain* Indicate names if submitting for multiple children

EMERGENCY CONTACT

Persons to be contacted in case of an emergency when parents cannot be reached. Please provide two contacts.

Contact 1*

First Name Last Name

Phone Number*

Relationship to child*

Contact 2*

First Name Last Name

Phone Number*

Relationship to child*

PICK-UP AUTHORIZATION

List name(s) of those (other than parents) authorized to pick up from school

TUITION AGREEMENT

*Please note that this form serves as a registration application to JUDA. Registration is NOT complete until a formal email has been sent detailing your child/ren's registration status.

*To enroll your child(ren) to JUDA, 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 a payment plan must be set up by the beginning of the school year.

Payment plans:

2 Installments | 1st payment - upon submission, 2nd payment - charged on 3 November 2026
4 Installments | 1st payment - upon submission, 2nd payment - charged on 3 November, 2026, 3rd payment - January 14, 2027, 4th payment - March 18, 2027

*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 force majeure closure days, or should the parents decide to withdraw the child from the program.

*In the event that tuition is not paid, Chabad Youth reserves the right to debit your Credit/Debit card, plus a $25 processing fee.

Please check*

I understand and agree to the tuition terms.

RELEASE OF INFORMATION AND PHOTOGRAPHS

Parents allow for child(ren)'s picture to be used for internal PR mailing and website and social media accounts 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.

Please check

I understand and agree.

PAYMENT

Registration Fee - $870
Material Fee - $100

I would like to pay*

Sponsorship opportunities

I would like to sponsor a child - $1,250

Payment method*

Credit CardOther

*

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

Please send payment to:

Zelle: [email protected]
Venmo: @MidtownChabad

Total

$5820.00

Yes, I'd like to donate the cost of processing this transaction by adding 3%

Please check*

I authorize Chabad Youth to charge my credit card submitted above for the scheduled charges.

As the parent(s) or legal guardian of the above child(ren), I/we authorize any adult acting on behalf of Chabad Youth to hospitalize or secure treatment for my child(ren), I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Youth personnel will try, but are not required, to communicate with me prior to such treatment. I acknowledge that the Chabad Youth personnel shall not be held liable for any injury, loss, damage, or expense arising from or related to participation in any program or activity. I hereby give permission for my child(ren) to participate in all school activities, join in class and school trips on and beyond school properties and allow my child(ren) to be photographed while participating in Chabad Youth activities and that these pictures may be used for marketing purposes.

Please check*

I accept.

Mother's signature*

First Name Last Name

Today's date*

Month Day Year

Father's signature*

First Name Last Name

Today's date*

Month Day Year

JUDA | Current Students

Ready for Another Amazing Year?

PARENT INFORMATION

STUDENT INFORMATION

Second Child

Third Child

EMERGENCY CONTACT

PICK-UP AUTHORIZATION

TUITION AGREEMENT

RELEASE OF INFORMATION AND PHOTOGRAPHS

PAYMENT