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REGISTRATION

Register your child for the new year.

REGISTRATION

We are currently accepting application forms for the 2024 – 2025 school year. Please fill out ALL fields of this form. If you have any questions or concerns you would like to discuss with us, please feel free to contact us.

Please click here for tuition rates.

Are you an existing student, returning for the new year? Register here.

We look forward to a wonderful year of learning and growth.

How many children are you registering today?
- 1
- 2
- 3
Child 1 Name*
First Last
Hebrew Name
DOB*
Date Format: MM slash DD slash YYYY
Age*
Gender*
- Boy
- Girl
School
Grade Entering*
Second Child
Child 2 Name*
First Last
Hebrew Name
DOB*
Date Format: MM slash DD slash YYYY
Age*
Gender*
- Boy
- Girl
School*
Grade Entering*
Third Child
Child 3 Name*
First Last
Hebrew Name
DOB*
Date Format: MM slash DD slash YYYY
Age*
Gender*
- Boy
- Girl
School*
Grade Entering*
Previous Jewish Education?
- Yes
- No
Where?
Were there any conversions or adoptions in the family?
- Yes
- No
Please provide details:
Parent Information
Parent 1*
First Last
Hebrew Name
Main Contact Number*
Parent 1 Email*
Parent 2
First Last
Hebrew Name
Main Contact Number
Parent 2 Email
Address*
Street Address Address Line 2 City State ZIP Code
Persons to be contacted in case of an emergency when parents cannot be reached. Please provide at two contacts.
Name 1*
First Last
Phone*
Relationship to child*
Name 2
First Last
Phone
Relationship to child
CONFIDENTIAL: Does your child have any allergies or other medical condition, require medication, or any special abilities or disabilities we should be aware of?*
- Yes
- No
Please describe them and indicate special precautions or care needed.
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Jewish Learning Academy to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment.*
- I Accept
It is understood that if time and circumstances reasonably permit, Jewish Learning Academy 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.*
- I Accept
I hereby give permission for my child to be photographed while participating in Jewish Learning Academy activities and that these pictures may be used for marketing purposes.
- I Accept
Options
- Sundays Mornings 9:30am - 12:00pm
- Wednesday Afternoons 4:00 pm - 5:15pm or 6:00 pm
Bar / Bat Mitzvah Private Tutoring
- Day & time to be determined.
In addition to the Ongoing Hebrew School lessons, special One-on-One Private Tutoring with the Rabbi preparing your child for their special day!
Payment Options*
- I will send a check for full payment
- Please charge my card in full (you will be redirected to payment after clicking Submit)
- Please charge my card in three installments (you will be redirected to payment after clicking Submit)
- Please have the office contact me to arrange payment
Please check one option.
Name*
Initials*
We look forward to a wonderful year of learning and growth!

Registration

New Student Registration
Returning Student Registration

Contact Us

(310) 214-4999
info@jccmb.com

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