Student Registration Form

  • Please ensure your family account is paid in full prior to enrolling in our school. All personal information will be kept strictly confidential.

  • First NameLast NameHebrew NameDate of BirthSecular SchoolAny Food Allergies 
  • First NameLast NameHebrew NamePhone NumberEmail Address 
  • NameRelationshipCell PhoneHome Phone 
  • Emergency Care Permission Although the recommendation of the parent will be respected as much as possible, I understand that in the final disposition of an emergency case, the judgment of the adults on site will prevail. I hereby give permission to JCNWJ Personnel to seek emergency medical treatment from the physician of their choice for my child.