Student Profile
First Name
Last Name
Hebrew Name
DOB
School
Grade Entering
Hebrew Reading Proficiency
Previous Jewish Education
Where?

Please select which track your child will be attending:

Track 1 Tuesdays  4-5pm (in person)
Track 2 Wednesdays 3:30-4:30pm (Virtual)
Track 3 Private Lessons

 
Parent Information
Father's Name
Phone
Mother's Name
Phone
Address
City
State
Zip
Email Address
 
Emergency Information
Emergency Contact 1
Phone
Emergency Contact 2
Phone
Doctor
Address
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.

FOR IN PERSON STUDENTS: 
Due to Covid-19: The morning of in person classes, each Parent is responsible to  submit an online Health Screening Questionaire, as well as inform us if any family members have been exposed to or have any symptoms associated with COVID-19, such as fever, difficulty breathing, coughing or loss of smell throughout the year.

 I will notify CHS of any Covid exposure/symptoms.

Payment Information

RSF Hebrew School of the Arts!
$120/month -Includes Textbooks and Supplies

Total Amount:

Check Payments  I will send in a check by mail.
Please consider an added donation to our scholarship fund
Credit Card Number
CVV
Expiration Date

 

Authorization
Transport / Emergency Care as listed above Authorization
 
Media Authorization