Registration Form - Required for enrollment

SHORASHIM ROOTS
First First day of school is Sunday, September 15, 2024
We are currently accepting application forms for the 2024-2025 school year. If you have any questions or concerns you'd like to discuss, please contact us at [email protected] or 206-383-8441.

Register before August 15, 2024: $1150 per student (must include registration and payment forms)
Registration fee: $1250 per student
Late enrollment fee after November 1, 2024 - $100 per student
Referrals: Save $30 for each new family that signs up!
One free-day trial for new students only
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*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Father*
First Name Last Name
Phone Number*

Area Code Phone Number
E-mail*

Address (if different)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

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

We are currently accepting application forms for the 2024-2025 school year. If you have any questions or concerns you'd like to discuss, please contact us at [email protected] or 206-383-8441.

First day of school is Sunday, September 15, 2024

Register before August 15, 2024: $1150 per student (must include registration and payment forms)
Registration fee: $1250 per student
Late enrollment fee after November 1, 2024 - $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 - 12:15 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 paid using a credit card.

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Registration

Required for enrollment

SHORASHIM ROOTS

1. STUDENT INFORMATION

2. PARENT INFORMATION

3. EMERGENCY INFORMATION

4. TUITION, DISCOUNTS & REFUNDS

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