Returning Families Park Hebrew Enrollment

Park Hebrew Enrollment
We are currently accepting application forms for the 2024-25 school year.

Thank you for once again choosing Park Hebrew!

1.Fill out the enrollment form
2. A tuition link will follow.

You will receive a welcome packet including the parent handbook and School calendar at the end of August.
Household Name*
Household Phone Number*
Primary E-mail

Address*

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

Emergency Contact Name*
First Name Last Name
Emergency Contact Phone Number*

Area Code Phone Number
Emergency Contact relation to student(s)*
Mother/ Parent #1 Information
Name*
First Name Last Name
Cell Phone*

Area Code Phone Number
Email*
Is Parent #1 Jewish?
Father/ Parent #2 Information
Name*
First Name Last Name
Cell Phone*

Area Code Phone Number
Email*
Is Parent #2 Jewish?
General Information
Are there any adoptions or religious conversions in the family? (Ex: Child, parents, grandparents)?*
If you answered yes to the above, please indicate who is adopted or converted and by which Beit Din*
* Kindly take note that Park Hebrew operates as a Bar & Bat Mitzvah preparation program, and as such, it adheres to the conversion policies of the Chicago Rabbinical Council office and the Chief Rabbinicate of Israel, which are applicable to officiated Jewish lifecycle ceremonies.
Be a part of it! Does either parent have a skill or resource they would like to volunteer/offer to Park Hebrew?
Child #1 Information
Child's Name*
First Name Last Name
Hebrew Name*
Birth Date*

Month Day Year
School your child attends*
Grade entering*
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.
Child #2 Information
Child's Name
First Name Last Name
Hebrew Name
Birth Date

Month Day Year
School your child attends
Grade entering
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.
Medical release Form
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad of Lincoln Park's Park Hebrew to treat, 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, Park Hebrew personnel will try, but are not required, to communicate with me prior to such treatment.
Electronic signature*
Signature Date*

Month Day Year
at Hour Minutes
Permissions
I/we understand that my/our child(ren) may be included in photographs and video footage that may be photographed or filmed during Park Hebrew. I authorize Park Hebrew and Chabad of Lincoln Park to use these photos/videos to promote its programs and services in print, web, and other promotional contexts.**

I agree
Payment
Upon filling out this form you will receive a link to set up your tuition payments

Tuition is $1,350.00 (Early Bird of 1,250.00 Before August 23rd) and includes complete year of Park Hebrew book fees, supplies and snacks. Tuition is non-refundable.

We believe that all Jewish children should have access to the best Jewish education. Funds shouldn't get in the way, period. If you feel you are in need of a scholarship, please visit our scholarship fund page and fill out the application form.
I would like to receive news and updates by email
Should be Empty:

This page uses TLS encryption to keep your data secure.

Park Hebrew Enrollment

Mother/ Parent #1 Information

Father/ Parent #2 Information

General Information

Child #1 Information

Child #2 Information

Medical release Form

Permissions

Payment