JUDA Registration Form

Primary Contact

First Name *

Last Name *

Phone Number *

Email *

Street Address *

City *

Postal Code *

State/Province *

Activity Subject

Secondary Contact

First Name *

Last Name *

Phone Number *

Email *

Share address

Same Address?

Street Address *

City *

Postal Code *

State/Province *

Relationship to Father Relationship Type(s)

How many kids do you want to apply for? *

Emergency Contact

First Name *

Last Name *

Phone Number *

Relationship to the kids

Authorization for Emergency Medical Care

In the event my child becomes ill or is injured at school or while under the supervision of the school, I hereby authorize any employee or representative of Gan Gani Preschool to obtain medical aid for my child. I have been advised by the school that it will exercise such authorization when I cannot be contacted in time. I acknowledge that charges for such medical care will be my responsibility and not that of Gan Gani Preschool.

Signature of Parent *

Date *

Month

Day

Year

Photo release authorization *

I hereby consent to allow the school to utilize photos and videos featuring my child/ren in promotional and marketing materials on our website, ads, and social media platforms. These captivating visuals will showcase the vibrant educational environment and the exciting activities taking place at our school, while also safeguarding the privacy and security of each student. Your support in sharing the joyous moments of their educational journey would greatly contribute to fostering a positive and engaging community.

Yes

Tuition Payment Options *

In full

5 monthly payments

Interval of Installments

JUDA Registration Form

Chabad Center for Jewish Life & Learning