Registration - TRIAL Class for New Students

Welcome to Aleph Bet Hebrew School A TRIAL class for New Students - No obligation.

Please fill out ALL fields of this form.

Please use a separate registration form per child.

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

If you have any questions, feel free to contact Mendy Lezell, Aleph Bet Hebrew School director, who will be happy to discuss any questions you may have.

Phone: 215-497-9925 ext. 3 | Email: [email protected]

You will only be charged after you decide to stay after the end of the month!

Child's Name

First Name Last Name Hebrew Name

Date of Birth*

Month Day Year

Grade Entering in September*

Choose one Aleph Bet option*

In Person - SundayIn Person - Wednesday

Father's Name

Full Name Hebrew Name

Father's Cell Phone

Area Code Phone Number

Father's E-mail

Mother's Name

Full Name Hebrew Name

Mothers Cell Phone*

Area Code Phone Number

Mother's E-mail*

Address*

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

Were there any conversions or adoptions in you family?*

YesNo

If yes, please explain:

Are the natural parents of the child Jewish? *

BothFather OnlyMother Only

Agreement

I understand that this registration is only for Hebrew school, and if I intent to have my child's Bar/Bat Mitzvah at Lubavitch of Bucks County, I will reach out to the office at 2154979925 ext.3 before registering my child, to discuss the Bar/Bat Mitzvah policy.

Emergency Contact

First Name Last Name

Relationship

Phone Number

Area Code Phone Number

Is there any special medical or other information regarding your child, of which our school should be made aware?

Does your child have behavioral support in his/her regular school? *

YesNoPart Time

Permission*

The Aleph Bet Program has my permission to arrange for any necessary first aid or care by a licensed physician for my child while he/she is attending school.

Registration - TRIAL Class for New Students

General Information

Family Information

Emergency Contact & medical Information

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