Shir Libeynu School: Jewish Learning Program Registration Form

SHIR LIBEYNU SCHOOL SUPPLEMENTAL LEARNING PROGRAM REGISTRATION FORM

The cost for the fall 2019 session of the Shir Libeynu School is $595 ($ 613 by Paypal). if your child is registered and payment is made by June 18, 2019. Once you submit this form, you will be directed to a page with payment instructions and with a link to the field trip, program and media waiver. Please note, in order to complete your child's registration, you must submit this form and make your payment.

Sibling Discount: If you have registered another child in your immediate family for either the fall 2019 session of the Shir Libeynu school or the 2019/20 Bnei Mitzvah Enrichment sessions, you will receive a 5% sibling discount for the second child. The cost for the second child is $ 565 ($583 by PayPal).

Optional Hebrew Instruction: We also offer an optional 1/2 hour hebrew instruction for children registered in the school. The hebrew instruction will take place at 9:15 am. The school sessions begin at 10 am. The cost for the optional hebrew instruction fall session is $250 ($258 by PayPal).

I am also registering my child for the optional hebrew instruction:

Yes

Name of Child (First and Last) *

Date of Birth of Child * +

Child's Email address:

Child's Hebrew Name *

Child's School *

Child's Grade *

Name of Parent/Guardian (1): *

Email address of Parent/Guardian (1): *

Phone Number of Parent/Guardian (1) : *

Type of Phone *

Phone Number of Parent/Guardian (1) :

Type of Phone

Name of Parent/Guardian (2):

Email address of Parent/Guardian (2):

Phone Number of Parent/Guardian (2):

Type of Phone

Phone Number of Parent/Guardian (2):

Type of Phone

Report abuse