Returning Student Registration How many children are you registering? 1234567 Father's name Mother's name Student(s)' name(s) email Phone Did the children have any changes in medical or allergy conditions? YesNo If so please explain $100 deposit, per child, is due with registration. The deposit will be deducted from the total tuition. Tuition includes security and book fee. Regular tuition: $1050Apply $50 sibling discount: $1000Apply $100 early-bird discount: Tuition is $950 Credit Card Expiration month 123456789101112 Expiration year 2122232425262728293031323334353637383940 We grant permission for our child(ren) to be photographed which may be used by the school for PR purposes We grant permission for you to use the payment method on file I hereby give permission, in the event of an emergency, for the Director, the Acting Director, or the Teacher at Chabad Weltman Hebrew School to take whatever steps may be necessary for the medical care of my child. I understand that in order for Chabad Weltman Hebrew School to assume responsibility for my child, I, or the person(s) whom I have designated to drop off and pick up my child, must sign my child in at the time of arrival and out at the time of departure. I understand that unless there is a need for immediate action, the order of the steps taken will follow, but will not be limited to, the outline below: 1. The parent/Guardian will be called. Note:If the parent/guardian is unavailable, the emergency contact person designated by the parent/guardian will be called. 2. Child's physician will be called. 3. If these efforts are unsuccessful the following steps will be taken (order may vary depending on the situation): a. Another physician will be called. b. The child will be taken to the nearest emergency room accompanied by a staff member. c. An ambulance will be called to take the child to the nearest emergency room accompanied by a staff member. In the event of an emergency, if I cannot be reached, I give consent for a Chabad staff member to transport my child to the nearest emergency facility, or to have my child transported by ambulance. I give consent to any emergency facility and physician to administer any necessary medical treatment to my child as the situation may warrant it. Name of parent/guardian filling this form Today's date Total: $100 deposit + $950 tuition ($900 if there's multiple siblings in West Boca Hebrew School, $850 if early bird registration) Total: $200 deposit + $1900 tuition ($1800 if there's multiple siblings in West Boca Hebrew School, $1700 if early bird registration) Total: $200 deposit + $1800 tuition Total: $200 deposit + $1700 tuition Total: $300 deposit + $2850 tuition ($2700 if there's multiple siblings in West Boca Hebrew School, $2550 if early bird registration) Total: $300 deposit + $3000 tuition Total: $300 deposit + $2850 tuition Total: $400 deposit + $3800 tuition ($3600 if there's multiple siblings in West Boca Hebrew School, $3400 if early bird registration) Total: $400 deposit + $4000 tuition Total: $400 deposit + $3800 tuition Total: $500 deposit + $4750 tuition ($4500 if there's multiple siblings in West Boca Hebrew School, $4250 if early bird registration) Total: $500 deposit + $5000 tuition Total: $500 deposit + $4750 tuition Total: $600 deposit + $5700 tuition ($5400 if there's multiple siblings in West Boca Hebrew School, $5150 if early bird registration) Total: $600 deposit + $6000 tuition Total: $600 deposit + $5700 tuition Total: $700 deposit + $6650 tuition ($6300 if there's multiple siblings in West Boca Hebrew School, $5950 if early bird registration) Total: $700 deposit + $6300 tuition Total: $700 deposit + $5950 tuition