STUDENT INFORMATION
Last Name
First Name
Hebrew Name
Home Address
Home Phone
Email
DOB / /
Age
School
Entering Grade
PARENT INFORMATION
Fathers Name
Hebrew Name
Occupation
Work Address
Mobile Phone
His Email
Mothers Name
Hebrew Name
Occupation
Work Address
Mobile Phone
Her Email
RELIGIOUS & EDUCATION INFORMATION
Synagogue Affiliation
Previous Hebrew School
Level of Hebrew Reading Proficiency:
None Basic Intermediate Advanced
Learning Disabilities? Yes No If yes, please describe:
Conversions or Adoptions in Family? Yes No If yes, please specify:
MEDICAL INFORMATION (Confidential)
Family Physician
Phone
Insurance Policy #
Up to date w/ vaccinations? Yes No Date of last tetanus:
Any special medical conditions?
Emergency Contact
Phone
Relation to Child
FORMAT OPTIONS
In-Person Sessions: Sunday Mornings, 1.5 - 2 Hour Length
This option includes in-person, small sized classes by grade. We will be meeting at the Chabad Center of Bethesda. The spacious, high-ceilinged Sanctuary with its high capacity air circulation and filtration systems will allow for upgraded preventative measures and proper social distancing. Staff and students over 5 yrs old will be wearing masks at all times, all who enter the premises will be screened, and we will be sanitizing surfaces regularly throughout the day. We will also be utilizing the outdoors as much as possible.
We are consulting with medical experts who are guiding us on the safest and best protocols to put in place for the in-person classes, and we will share all the details once they are finalized. Please be assured, the safety of our students is our first priority, above all else.
'Out-Of-The-Box' Live Virtual Sessions: Sundays (alt days possible) 1 - 1.5 hour length
Students will remain at home and log on for live Zoom sessions with a teacher. We understand that virtual learning is challenging for many children, and we are doing our best to make this option as "out of the box" and as engaging as possible. We are working again with the CKIDS Global Network that have done a stellar job in preparing materials at the end of last year's school semester and throughout the summer forthe camp programming. They are currently working with professionals to create engaging curricula for remote learning, and will be training our staff in Zoom proficiency and in making this platform interactive and relational.
In addition, we will be preparing exciting, individualized boxes with materials needed for each week's lesson that will be available for each student who is joining this track.
TUITION COSTS FOR BOTH TRACKS $850 + $50 Book/Materials Fee
Payment Options:
Full payment now ($900) 50% payment now ($450) and 50% payment by Jan 1, 2021
Monthly ($200 Deposit now, $75 for 10 months (includes $50 installment fee)
Deposit only ($200 - spot reserved only)
Mode of payment:
Online Credit Card Payment Please fill out CC information below. Payment processed and spot reserved immediately
Mail In Check Please make checks payable to 'Chabad of Bethesda' with 'Hebrew School Tuition' in memo line. All checks must be mailed to Chabad of Bethesda, 5324 Goldsboro Rd, Bethesda, MD 20817
NOTE: Space reserved only upon receipt of check and payment processed
AGREEMENT
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of B-CC 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, B-CC Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in B-CC Hebrew School activities and that these pictures may be used for marketing purposes.
COVID-19 ADDENDUM: (For those opting for the In-Person Sessions): I hereby agree to follow all protocols as defined in the chart below, I also agree to retain sole responsibility for the decision to send my child(ren) to Chabad of Bethesda and participate in these In-Person Hebrew School Sessions. I will not hold Chabad of Bethesda responsible for any and all Covid-related developments that may result from this arrangement.
Digital Signature (please type full name) Date