BMC Register

Child's Information
Child's Name
First Last
Hebrew Name
Age
Birthday
School child will be entering in the Fall:
Grade child will be entering in the Fall
Mother's Information
Mother's Name
Mother's Hebrew Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
E-mail
- Please send all Hebrew School/ BMC Correspondence
Father's Information
Father's Name
Father's Hebrew Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
- Please send all Hebrew School/ BMC Correspondence
CONVERSION
If mother and/or child is a convert, please submit conversion forms.
Max. file size: 50 MB.

PLEASE NOTE : acceptance into Hebrew school does not affirm or deny the authenticity of your child's religion.
Emergency Contact
In the rare case that there is an emergency and we cannot reach either parents please let us know who we can call.
Name
First Last
Relationship
Cell Phone
Home Phone
Medical Information
Physician's Name
Phone
Insurance Company
Policy Number
- I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency.
Special Needs
Help us be the best advocate for your child and ensure the safest and most productive learning environment.
Does your child have special needs?
- Allergies
- Academic
- Behavior
- Social
- Physical
- Medical
Please explain:

Bat Mitzvah Club Registration

Child's Information

Mother's Information

Father's Information

CONVERSION

Emergency Contact

Medical Information

Special Needs

Class Information

Payment Information for Sunday OR Tuesday and for Sunday AND Tuesday

Payment Information Sunday AND Tuesday Hebrew School

Permission Slips