Student Registration

Wilshire Hebrew School

Where Judaism Comes Alive

Father's Full Name*

Father's First Name Father's Last Name

Father's Phone Number*

Father's E-mail*

Father's Occupation

Mother's Full Name*

Mother's First Name Mother's Last Name

Mother's Phone Number*

Mother's E-mail*

Mother's Occupation

Marital Status of Parents*

Is the child's father Jewish?*

Through birthThrough conversionNot Jewish

Was the child's mother born Jewish?*

YesThrough conversionNo

Please Specify The Ethnicity*

Was the child's maternal grandmother (mother's mother) born Jewish?*

YesNo

Please Specify The Ethnicity*

Were there any conversions or adoptions in your family?*

YesNo

Please Specify the Conversion*

Is there anything important we should know about your family? Please share any family matters that would help us care for your child — for example, adoptions, a recent loss (G-d forbid), or any other circumstance. Anything you share is kept confidential.

Picture of your child*

Child's full name*

Child's First Name Child's Last Name

Child's full Hebrew name*

Child's birth date*

Month Day Year

Child's gender*

Child's primary address*

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

School currently attending*

Which grade will your child be entering for the 2026–2027 school year? (TK–5th)*

Previous Jewish education please include preschool, Jewish camp, and any previous Hebrew school

Please share your child's Hebrew reading level:*

Does your child have any learning differences or needs we should know about? for example, dyslexia, ADHD, or anything that affects how they learn

This is important for us to know. The more we understand, the better we can guide and support your child, and anything you share is kept completely confidential.

Emergency contact name*

Child's relationship to emergency contact*

Emergency contact phone number*

Please list any allergies, medical conditions, or medications we should know about.

We are a nut-free environment (no tree nuts or peanuts).

Check all that interest you:

Anything you'd like to share? Have a skill, an idea for a program, or another way you'd love to help? We'd love to hear it.

Tuition is $1,400 for the year, with a $90 sibling discount for each additional child. Register by August 15 to lock in this rate, a late registration fee applies after that date. Tuition should never stand in the way of a Jewish education, if you are experiencing financial strain and cannot afford tuition, reach out to the office.

Is this registration for an additional child? Your first child pays full tuition. Each additional child from the same family gets $90 off, so only use this if another child from your family is also enrolled this year.

Yes, this is an additional child, and a sibling from my family is also registered.

Please enter the name of the sibling already registered:*

Sibling discount

Payment Plan (choose one):*

Pay in full by checkPay in full by credit cardPayment plan - 4 monthly installments by credit card

I understand my child's place is not reserved until we receive the check. Please make the check payable to Chabad Wilshire Corridor for the full amount due ($1,475 for one child + post Aug 15 fee), and mail or drop it off to 919 Malcolm Avenue, Los Angeles, CA 90024*

Yes

I agree to be charged the full tuition, plus a 3% credit card fee.*

Yes

I agree to be charged in 4 equal monthly installments, each plus a 3% credit card fee.*

Yes

Please make your check payable to Chabad Wilshire Corridor for the full amount due ($1,475 for one child + post Aug 15 fee), and mail or drop it off to 919 Malcolm Avenue, Los Angeles, CA 90024. Your child's place is reserved once we receive it.

Post August 15 Fee*

I Understand

Total

$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

By submitting this form and signing below, I confirm that I am the parent or legal guardian of the child named above and that the information I have provided is accurate, and I will update the school if it changes. I give permission for my child to take part in all Wilshire Hebrew School classes, programs, and supervised trips, on and off the premises, including transportation. If my child is injured or ill and I cannot be reached, I authorize the school to seek emergency medical care, and I agree to cover its costs. I understand that participation carries inherent risks, and to the fullest extent permitted by law I release and hold harmless Wilshire Hebrew School, Chabad of the Wilshire Corridor, and their staff and volunteers from any claims arising from my child's participation, except those caused by gross negligence or willful misconduct, and I accept responsibility for any damage caused by my child. I also give permission for my child to be photographed or recorded during Wilshire Hebrew School activities, and for those images to be used for the school's educational and promotional purposes. I have read and understood these terms and am signing electronically with the same effect as a handwritten signature.

I have read and accept these terms*

Yes

Electronic Signature*

Date*

Month Day Year

I would like to receive news and updates by email

Welcome to Wilshire Hebrew School!

Father's Information

Mother's Information

Family's Information

Child's Information

Emergency & Health Information

Get Involved

Tuition & Payment

Electronic Signature / Authorization