Returning Student Registration - Chabad Jewish Center of Olympia

Parent's Name

First Name Last Name
Child's Name*

First Name Last Name
E-mail
A copy of last year's registration form was sent at that time to the email address of the parent who submitted it. Please review it and ascertain whether any of the personal, contact, parental, medical and emergency information has changed over this past year. If you cannot find it please email [email protected] and we will be glad to send you a copy of your submission.
*

I have reviewed the registration form I submitted last year and will report any changes
Please specify any changes:
Payment
Cost for participation in JUDA is $450 for the 2019-20 school year. Please use options below to submit payment today. If you need to pay using a different method, would like a scholarship or have other questions on this topic email [email protected] and click other. Payment will not be charged until acceptance is confirmed.
Registration Fee

$450
Total

$0.00

Payment

Credit Card Other

Postal / Zip Code

Country

I will notify the facility immediately of any changes to the information provided on this form.

I allow for photos of my children while participating in JUDA to be shared on social media, and in all other promotional materials, for newsletter and PR purposes.

I give permission for my child to participate in all activities of JUDA - on site, off site and on trips.

I give my consent for emergency medical treatment to be administered to my child in case of an injury.

I AFFIRM THAT ALL THE INFORMATION PROVIDED IN THIS FORM IS TRUE.
Parent's Initials
Month Day Year
Please note: Acceptance to JUDA is only confirmed once you receive an email confirming your child is accepted.
I would like to receive news and updates by email
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