HS Registration - Returning Students - Chabad Lubavitch of Greenwich

Primary Address*

1st Child's Name*
First NameLast Name
1st Child Grade entering*as of September 1, 2021
2nd Child's Name
First NameLast Name
2nd Child Grade enteringas of September 1, 2021
Additional notable InformationPlease let us know if there are any allergies or other important information we need to be aware of.
Change of InformationIf there was a change since last year, please provide updated address, phone number, emergency contact info, and School attending.
I am willing to assist in school activities, please contact me
Payment: $1000. Security fee: $100 per family.
Payment Amount
$

Payment

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Payment: $1000. Security fee: $100 per family.