Register Online

We are currently accepting application forms for the 2017-2018 school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us at 949 770-1270.

Please note that one registration form per child is needed.

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

Student Profile
 
Name
Last
Hebrew Name
DOB
School
Grade Entering as of 09/2017
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No
Where?

Choices: Choose all that apply

Hebrew School Younger Division, Grades K-2, $625 + $50 Registration + $15 Book

Hebrew School Older Division, Junior CTeeN and CTeeN, Grades 3-12, $845 + $50 Registration + $35 Book

Bat Mitzvah Discovery Course $300

Bar Mitzvah Discovery Course $300

Parent Information
 
Father's Name
Phone
Mother's Name
Phone
Are the natural parents and grandparents of the child Jewish by birth? Yes No
If no please explain
Address
City
State
Zip
Her Email Address
His Email Address

Emergency Information
 
Emergency Contact 1
Phone
Emergency Contact 2
Phone


CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.


As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of the CJC 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, the CJC Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in the CJC Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept

Name: Initials:

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

Your application is not complete without a payment plan.

Payment options

Pay in full before or on 9/1/2017 
Pay in two installments 9/1/2017 and 1/1/2018.

Pay in 9 equal payments, beginning September 1 ending May 1st.

Payment Method

 

Check Option

I will setup automatic bill pay with my bank to send bank check to Chabad of Mission Viejo


 

Head Check Option

I will mail or bring in (2 or 9) postdated checks for full payment

 

Credit Card Option

 

Bill my credit card. I understand that there is a 3% surcharge to cover the service fee

Credit Card Information

Enter amount to be charged. The minimum is $50 to reserve your spot or a larger amount up to the full tuition fees. If you do not pay in full now, you will be billed the difference.

 
Card Type
Name (on credit card) First Last
Credit Card Number

 
Expire Date Amount