Student Information
First Name *
Last Name *
Jewish Name
Gender *  Male  Female
Date of Birth *   
Allergies? *

 Yes  No

Is there anything else we should know about your child?
   

 

Parent Information
Father Mother
Title *  Mr.  Dr. Title *

 Mrs.  Ms.

 Dr.

Name *
Name *
Home Phone *
Home Phone *
Cell Phone *
Cell Phone *
Work Phone
Work Phone
Email *
Email *
Occupation
Occupation
Home Address *
Home Address *
City *
City *
Province *
Province *
Postal Code *
Postal Code *

Is the father Jewish? *


Is the mother Jewish? *

 

Have there been any conversions or adoptions in the family (please specify)? *

 

Emergency Contact Information
Emergency Contact 1 Emergency Contact 2
Name *
Name *
Relationship to Child *
Relationship to Child *
Home Phone *
Home Phone *
Cell Phone *
Cell Phone *
Child's Sask Health Number *

 

Terms of Registration
Terms
*Enrolment in Yeladim Junior Jewish Academy is not a confirmation of the student's Jewish status.
Date *
Signature *

 

Tuition Details

$200 per term (four Sundays a month, 10am-12pm)

Alternatively, you may send a cheque for this amount to:

Chabad of Saskatoon - 105-906E Duchess St., Saskatoon, SK S7K 6K3

No one is turned away for lack of funds

Credit Card Type
Cardholder Name
Credit Card Number
Expiration Date