Register Online - New Student - Chabad Owings Mills

CHILD'S INFORMATION
Child's Name*
First Name Last Name
Jewish Name
Date and time of Birth* Time allows us to calculate Hebrew birthday

Month Day Year
Hour Minutes

Address*

Phone Number*

Area Code Phone Number
School Attending
Grade (2026-2027)*
Is the natural mother of the child born Jewish*

YesNo
Are there any conversions in the family?*

YesNo
Please include who converted and name of officiating rabbi
Are there any adoptions in the family?*

YesNo
Please provide adoption details
Does your child have any special learning needs, an IEP, or receive any behavioral or educational support in school? Please specify, as this information will help us better cater to the needs of your child.
PARENT'S INFORMATION
FATHER*
First Name Last Name
Occupation
Cell Phone*

Area Code Phone Number
E-mail*
MOTHER*
First Name Last Name
Occupation
Cell Phone*

Area Code Phone Number
E-mail*
EMERGENCY INFORMATION
Doctor's Name

Doctor's Address

Allergies If any, please list
Medical Conditions and/or Medications If any, please explain
Emergency Contact
First Name Last Name
Phone Number

Area Code Phone Number
Relationship
As the parent(s) or legal guardian, I/we authorize any adult acting on behalf of Chabad Hebrew School of Owings Mills 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 attend all field trips and outings sponsored by Chabad Hebrew School. I also allow Chabad to use my child’s picture for promotional purposes.
Initials to indicate approval*
IMPORTANT: After completing this registration form, please fill out a Tuition form.

Click here for the Tuition form or visit www.ChabadOM.com/5962757
Should be Empty:

This page uses TLS encryption to keep your data secure.

CHILD'S INFORMATION