CCHS 2018-2019 Registration Form
Sign up your children now for Hebrew School 2017-2018! For more information please email rivkie@chaicenter.net
Student Information
Last Name *
Your answer
First Name *
Your answer
Hebrew Name
Your answer
Date of Birth *
Your answer
Grade Entering in Secular School: *
Your answer
Home Address *
Your answer
Is the natural mother of the child/children Jewish by birth? *
If converted, by:
Your answer
Is the natural father of the child/children Jewish by birth? *
If converted, by:
Your answer
Allergies or other medical conditions we should be aware of?
Your answer
Learning disabilities or other issues that we should be aware of?
Your answer
Are you registering any more children? *
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