Hebrew School Registration

Child 1 Information
Full Name*
First NameLast Name
Hebrew Name*
Birth Date*Help us find out your child's Hebrew birthday
MonthDayYear
School*
Grade Entering*
Student's Jewish Knowledge
Additional Notable InformationPlease let us know of any other important information that you would like us to be aware of.
Child 2 Information
(If applicable)
Full Name
First NameLast Name
Hebrew Name
Birth DateHelp us find out your child's Hebrew birthday
MonthDayYear
School
Grade Entering
Student's Jewish Knowledge
Additional Notable InformationPlease let us know of any other important information that you would like us to be aware of.
Parent Information
Father's Name*
First NameLast Name
Father's Hebrew Name
Father's Cell*
Area CodePhone Number
Father's E-mail*
Father's Ocupation
Mother's Name*
First NameLast Name
Mother's Hebrew Name
Mother's Cell*
Area CodePhone Number
Mother's E-mail*
Mother's Ocupation
Mother Jewish by*
BirthChoice

Address*

Home Phone Number
Area CodePhone Number
Is there any conversion or adoption in the family?*
If yes, please elaborate. (all information will be kept confidential)
Voluntering*
I would like to get involved in Hebrew School activities.I am not able to get involved in Hebrew School activities
Grandparents' Information
Paternal Grandfather*
First NameLast Name
Hebrew Name
Paternal Grandmother*
First NameLast Name
Hebrew Name
Maternal Grandfather*
First NameLast Name
Hebrew Name
Maternal Grandmother*
First NameLast Name
Hebrew Name
Emergency Information
Emergency Contact*
First NameLast Name
Relationship*
Phone Number*
Area CodePhone Number
Please list any allergies or medications that the child is taking
Doctor*
First NameLast Name

Doctor's Address*

Doctor's Phone Number*
Area CodePhone Number
Medical Insurance*
Policy #*
Will your child(ren) be joining Hebrew School in person or online?*
My child(ren) will join in personMy child(ren) will join online
Authorization
I give permission to Aleph Hebrew School at MSC, and those authorized by Manhattan Sepharadic Congregation and Aleph Learning Center, to take photographs and to make recordings of my children and my family, and to use them in original or modified form in all media now or hereafter known, with or without my name or information about me, for the promotion, public education, and/or fundraising activities of Aleph Learning Center and/or Manhattan Sepharadic Congregation.
*
I give permissionI don't give permission
As the parent(s) or legal guardian I/we authorize any adult acting on behalf of the Hebrew After-School Program at MSC 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 Hebrew After-School Program personnel will try, but are not required, to communicate with me prior to such treatment.
*
I authorize all that is written above
Signature*Full name
Thank you for applying! Please note that all applications will be reviewed and acceptance is only confirmed after receiving an acceptance letter.
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Authorization