Registration Form 2026 - Chabad of Universal City

Child(ren)'s Information

How many children are you registering?*

1. Full Name*

First Name Last Name

Birth Date*

Month Day Year

Grade*

2. Full Name

First Name Last Name

Birth Date

Month Day Year

Grade

3. Full Name

First Name Last Name

Birth Date

Month Day Year

Grade

Address*

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

Parent's Information

Mother's Name*

First Name Last Name

Phone Number*

Area Code Phone Number

E-mail*

Father's Name*

First Name Last Name

Phone Number*

Area Code Phone Number

E-mail*

I would like to receive news and updates by email

Is the natural mother of the child Jewish?*

YesNo

Any conversions in the family? *

YesNo

If yes, please specify:

Please Note: Acceptance into Hebrew School does not confirm Jewish status.*

Noted

Medical Information

Is your child currently taking any medication?*

YesNo

Does your child have any allergies?*

YesNo

If yes, please provide any additional relevant information. (If signing up more than one child, please specify whom.)

Is there any medical or other information that we should be aware of?**

YesNo

If yes, please describe.

Emergency Contact #1*

First Name Last Name

Emergency Contact #1 Phone*

Area Code Phone Number

Emergency Contact #2*

First Name Last Name

Emergency Contact #2 Phone*

Area Code Phone Number

Please note: submission of this form does not guarantee acceptance. All applications are subject to review and confirmation.*

Noted

Payment Information

Hebrew School Tuition

Full Tuition: $1,000 per child
Subsidized Tuition: $850 per child

Families with more than one child receive $50 off for each additional sibling, whether choosing full tuition or subsidized tuition.

There is a $50 registration fee, charged at registration. This fee will be applied toward tuition.

Early Bird Special:
Register before August 1, 2026 and receive $50 off per child.

Select tuition option*

Full tuitionSubsidized tuition

I am signing up:*

One Child = $1,000Two Children = $1,950Three Children = $2,850

I am signing up:*

One Child = $850Two Children = $1,650Three Children = $2,400

I would like to pay the tuition:*

All at once on the first day of Hebrew SchoolWith monthly installments (Oct-May). The payments will be processed automatically every month with the credit card you will provide below.

Payment

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

Total

$0.00

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad of Universal City or The Studio City Neighborhood 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, The Chabad of Universal City or The Studio City/Universal City Neighborhood 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 The Neighborhood Hebrew School activities and that these pictures may be used for marketing purposes. The Studio City/Universal City Neighborhood Hebrew School is a program under Chabad of Universal City and reserves the right to terminate this registration at any time and refund the balance paid.

*

I Accept

Name*

My e-signature will be legally binding as a printed signature