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Student Information
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Last Name
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First Name
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Hebrew Name
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Gender
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Date of Birth
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Address
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City
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Province
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Postal
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Home Phone
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Previous School
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Note
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Medical Information
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Physician Name
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Physician Phone
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Insurance
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Ohip Number
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Allergies
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Medical Note
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Parent Information
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Father
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Title
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First Name
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Last Name
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Work Phone
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Cell Phone
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Email
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Mother
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First Name
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Last Name
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Work Phone
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Cell Phone
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Email
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Marital Status
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Have there been adoptions or conversions in the family?
If Yes, Please explain
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Is mother Jewish from birth?
Is Maternal Grandmother Jewish from birth?
If no to either of above questions, please explain:
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Emergency Information
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Emergency 1
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Emergency 2
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Emergency 3
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Tuition & Fees
September 2023-June 2024
Tuition: $700 (5% sibling discount)
Early bird - Register by Aug 30 - $50 off per child
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Ages 5 - 12:
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Sunday 10:00 - 12:00
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Payment Information
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Method of payment
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Card Type
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Card Number
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Expiration Date
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Security Code
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Name on Card
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Billing Address
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Billing Postal Code
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I agree to the terms and conditions above
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