Register

Moldau Hebrew School Registration
We are currently accepting application forms for the upcoming school year. Please fill out ALL fields of this form. Space is limited for the coming year.

We look forward to a wonderful year of learning and growth.
Tuition fee is all inclusive of security fees, supplies, and also includes Ckids club event experiences.

Siblings - New This Year:
First child is regular price. Siblings will receive $50 dollars off tuition.
Parent Information
Father's Name:*
First Name Last Name
Father's Email:*
Father's Cell Phone Number:*
Mother's Name:*
First Name Last Name
Mother's Email:*
Mother's Cell Phone Number:*

Address:*

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

Are the natural father and mother of the child(ren) Jewish?*

YesNo
If no please explain:
Any adoptions or conversions in the family?*

YesNo
If Yes, Please Explain:
What are your hopes and goals for your child(ren) joining Hebrew school?*
How many children are you registering?*
Student Profile - Child 1
Full Name*
First Name Last Name
Hebrew Name:*
DOB:*

Month Day Year
Grade Entering:*
School:*
Hebrew Reading Proficiency: *

NoneSomewhatWell
Previous Jewish Education:*

YesNo
Where?
Allergies If any, please explain:
Medical Conditions. If any, please explain:
Does your child have an IEP or receive any behavioral or educational support in school? Please explain. (Sharing this information with us enables us to create a Hebrew School environment in which your child can thrive)
Student Profile - Child 2
Full Name*
First Name Last Name
Hebrew Name:*
DOB:*

Month Day Year
Grade Entering:*
School:*
Hebrew Reading Proficiency: *

NoneSomewhatWell
Previous Jewish Education:*

YesNo
Where?
Allergies If any, please explain:
Medical Conditions. If any, please explain:
Does your child have an IEP or receive any behavioral or educational support in school? Please explain. (Sharing this information with us enables us to create a Hebrew School environment in which your child can thrive)
Student Profile - Child 3
Full Name*
First Name Last Name
Hebrew Name:*
DOB:*

Month Day Year
Grade Entering:*
School:*
Hebrew Reading Proficiency: *

NoneSomewhatWell
Previous Jewish Education:*

YesNo
Where?
Allergies If any, please explain:
Medical Conditions. If any, please explain:
Does your child have an IEP or receive any behavioral or educational support in school? Please explain. (Sharing this information with us enables us to create a Hebrew School environment in which your child can thrive)
Emergency Information
Doctor’s Name:*

Doctor's Address:

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

Emergency Contact Other Than Parent:*
Phone Number*

Area Code Phone Number
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of the Chabad Hebrew School to 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, the Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in the Chabad Hebrew School activities and that these pictures may be used for marketing purposes.
*

I hereby give permission for my child to attend all field trips and outings sponsored by Chabad Hebrew School.
*

I hereby give permission for my child to be photographed. Photos may be used for promotional purposes for Chabad Lubavitch of North Orlando.
Full Name of Parent:*
First Name Last Name
Initials:*
Payment Information
Your application is not complete without a payment plan. Moldau Hebrew School does not reject anyone due to lack of funds. If you feel that you need a special payment plan please call our office at 407-636- 5994.Tuition Cost: $1,150 per child. Registration fee: $50.If this form is submitted before, May 30, 2026 a discount of $100 will be deducted from the tuition amount.
Payment options:*

Pay in full (charged August 1)Two installments (charged Aug 1 and Jan 1)10 monthly payments (starting Aug 1, charged monthly)
Total to be charged today:

$0.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

*

Use this same credit card for hebrew school paymentsUse my card on file for hebrew school payments
Should be Empty:

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Educate Your Child... Educate a Generation

Moldau Hebrew School Registration

Parent Information

Student Profile - Child 1

Student Profile - Child 2

Student Profile - Child 3

Emergency Information

Payment Information