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JewQ Aleph Champ Registration 2026-2027

Student Profile
Full Name*
First Name Last Name
Hebrew Name*
Gender

MaleFemale
Birth Date*

Month Day Year
Time of day born Please specify AM or PM
Hour Minutes
School*
Grade Entering* Grades K -7
Hebrew Reading Proficiency*

WellSomewhatNone
Previous Jewish Education*

YesNo
Where?
Jewish Family Background
Father*
Mother*
Maternal Grandmother*
Were there any adoptions or conversions in the family?*

yesno
If yes, please elaborate
Parent Information
Father's Name*
First Name Last Name
Father's Cell*

Area Code Phone Number
Father's Email*
Mother's Name*
First Name Last Name
Mother's Cell*

Area Code Phone Number
Mother's Email*
Home Phone

Area Code Phone Number

Address*

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

Emergency Contact Information
Name*
First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
Child's physician or medical facility
Phone Number

Area Code Phone Number
Health Insurance
Group #
ID #
Does your child have any allergies or other medical condition we should be aware of?*

yesno
If yes, please describe and indicate precautions or care needed.
Does your child take behavioral medication during regular school hours?

YesNo
Are there any learning styles which work best for your child? Please detail them here.
Terms of Agreement
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad 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, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment.
*

I Agree
I allow my child to be photographed during Hebrew School. I understand that these photos may be used on social media. Name of child will not be included in publicity without separate additional parental permission for the specific media.
*

I Agree
Initial Here:
Payment Information
The tuition for the JewQ Aleph Champ is $600.00 per year per child. This includes a minimum of 12 sessions approximately 50 minutes each.

You have the option to pay the full amount up front or to pay in two installments, the first being due up front and the second one being due after the first 4 sessions.

The program uses multi-media, review games, and a text book called "Jewish Living". This text book goes through all the years. You will only need to purchase it one time if you don't already have it.
Tuition* Select your payment option. We will be in touch for any balances.

$600 - Full payment$300 - 1st payment
Payment

$0.00 USD

Payment

Credit Card eCheck Check

Postal / Zip Code

Country

How did you hear about Chabad Hebrew School?
One more thing... T-shirt size
T-shirts will be provided in March for each JewQ student. Please choose the size that you believe will work best for your child in March and write it in the box. Youth Small. Youth Medium. Youth Large. Adult Small. Adult Medium. Adult Large.*
I would like to receive news and updates by email
For questions or comments, feel free to contact our Education Director, Chanie Fogelman at [email protected]
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