Registration Form - Required for enrollment

SHORASHIM ROOTS
Rosh Hashanah Art Fair - Sunday Sept. 14, 2025
First day of school - Sunday, Sept. 28, 2025
We are currently accepting application forms for the 2025-2026 school year. If you have any questions or concerns you'd like to discuss, please contact us at [email protected] or 206-383-8441.

Early bird discount: $100 discount if registered and payment is received by August 1, 2025
Registration fee: $1250 per student (must include registration and payment forms)
Late enrollment fee after November 1, 2025 - $100 per student
Referrals: Save $30 for each new family that signs up!
One free-day trial for new students only
Time: Sundays, 10:00 am - 12:30 pm
1. STUDENT INFORMATION
Student's Name*
First Name Hebrew Name Last Name
Birth Date*

Month Day Year
Age*
What age will be the student's be in September 2024?
Gender*

MaleFemale
T-Shirt size*
Does your child speak/understand Hebrew?*

NoneWellSomewhat
Does your child have a previous Jewish education*

YesNoSomewhat
If yes, please describe*
What school does your child attend?*
Grade?*
What will be the grade the student will be entering this school year?
What else would you like us to know about your child?
Have there been any conversions or adoptions in the family? If yes, please explain.
Does your child have any allergies?*
2. PARENT INFORMATION
Mother*
First Name Last Name
Phone Number*

Area Code Phone Number
E-mail*

Address*

Address (if different)

Marital Status*

MarriedDivorcedSeparatedDeseased
Mother born Jewish?*

YesNoConverted (See note below)
NOTE: We accept conversions recognized by the rabbinical courts in Israel (Rabanut of Israel).
Converted by whom?
Volunteer?

YesNoMaybe
3. EMERGENCY INFORMATION
Emergency Contact*
First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
4. TUITION, DISCOUNTS & REFUNDS
Tuition, Discounts & Late Enrollment

Early bird discount: $100 discount if registered and payment is received by August 1, 2025
Registration fee: $1250 per student (must include registration and payment forms)
Late enrollment fee after November 1, 2025 - $100 per student
Referrals: Save $30 for each new family that signs up!
One free-day trial for new students only
Time: Sundays, 10:00 am - 12:30 pm

* Synagogue membership is NOT required. Please note that no child will be turned away due to lack of funds. Please contact the office us to discuss any financial considerations.

Refund Policy

Should you decide to withdraw your child from Hebrew School, your refund will be pro-rated up to November 30th. After that date no refund will be allowed for school tuition. There is no refund on books and supplies.

There is no refund or credits for days missed due to illness, holidays or family vacations.

Credit card processing fee of 3% for all refunds.

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