***Refer a friend and get $50 off!! 

Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us.

If you would prefer to fill out this paper and mail it into our office, a PDF can be found here. Registration Form 09.pdf

Mail completed forms and registration form to:

Shul by the Shore
5855 Naples Plaza # 315
Long Beach, Ca 90803

Please note that one registration form per child is needed.

Student Profile
Hebrew Name
Gender Male Female
Grade Entering
Hebrew Reading Proficiency None Somewhat Well
Previous Jewish Education Yes No
Any considerations, such as learning disorder or difficulty, the school should be aware of? (Confidential):
Parent Information
Father's Name
Cell Phone
Mother's Name
Cell Phone
Email Address where you would like updates, news and events about Hebrew School sent:
Emergency Information
Emergency Contact 1
Emergency Contact 2

CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed.

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Chabad Hebrew School activities and that these pictures may be used for marketing purposes.

I Accept

Name: Initials:

I heard about the Shul by the Shore Hebrew School from:

We look forward to a wonderful year of learning and growth!