Registration Form

Student 1 Profile

Hebrew Reading Proficiency *

Student 2 Profile

Hebrew Reading Proficiency *

Student 3 Profile

Hebrew Reading Proficiency *

Parent Information

The biological parents of these children were born Jewish Select all that apply *
Are there any conversions in the family? *

Emergency Contact One

Emergency Contact 2

Health & Terms

In case of accident or illness it is agreed that if the parent or emergency contact cannot be
reached, Camp Chabad Hebrew Shcool has permission to provide medical care. I also authorize
the Chabad staff to administer minor first aid (for cuts, scrapes, etc.) if the need arises.
I give my child permission to participate in all Hebrew School activities and trips. In addition,
Camp Chabad Winter Hebrew School can use photographs of my child in its public relations programs.
Signiture *

Payment Information

Synagogue membership is NOT required! No child will be turned away due to lack of funds.
Payment plans are available, we will be in touch with you for further details.
Payment breakdown is as follows: First child is $750 tuition plus $60 registration fee . 10%
discount applies to each additional child.
If payment is not made in full, you will receive an invoice and will be contacted by the
Chabad office to make payment arrangements.
I would like to pay today *
Payment method *
Venmo: @campchabad 
Cashapp: $campchabad 
mail a check to:
Camp Chabad 
1435 Vine Street 
Cincinnati OH 45202 
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