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Student Info (as of 9/01/16):
Child #1

Child #2

Child #3

Previous Hebrew Education:
Child # 1

Child # 2

Child # 3

Family Information:



Phone Home: Work: Occupation:



Phone Home: Work: Occupation:

Child (ren)’s email address:

Are the natural parents of the child (ren) Jewish? Father Mother

Were there any conversions or adoptions in your family? yes no.
If yes please explain:

Other children living at home (name and ages):

Does your child have any learning difficulties with general studies? explain:

Medical Information:

Is there any special medical or any other information regarding your child, which our school should be aware of?
Emergency Contact: Name: Phone: Relationship:

I hereby permit my child (ren) to participate in all school activities and join in school trips on and beyond school properties. In case of emergency, I hereby authorize the school to have my child taken care of by a physician in any way the situation may call for.

I am willing to assist in school activities – please contact me.

2809 SW Sunset Trail, Palm City, FL 34990 (772) 288-0606

*Enrollment in CJC Hebrew School does not automatically entitle you to a Bar/Bat Mitzvah. An appointment should be scheduled with the Rabbi to discuss this.


School Calendar Tuesday, Time 4:30 pm - 6:30 pm

Tuition Fees: $500 Book & Supply fee $45

Family discount: 5% for second child. Partners of Chabad (who donate one share of Chabad’s fundraising budget) 10% discount.

Payment Options: 
All registrations most be accompanied with at least a $100 deposit Book fee must be paid at registration or before beginning of year.

Tuition Payment Options: 
Option #1 I will send a check of the payment in full of $ due August 1 
Option #2 I will be paying the tuition in two installments of $ 
Payment # 1 due on August 1 - Payment # 2 due on January 2 
Option #3 I will be paying the tuition with head checks in ten installments of $ 
Payment # 1 due on August 1 - Payment # 10 due on May 1

Please make checks payable to: CJC Hebrew School.

Credit Card option with an added 3% convenience charge 
Name on card: 
 amount to charge  
Number: ex: M/Y Code: Zip: 


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