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Judea Kids Club

Inspiring Jewish Pride and Identity in Jewish Children - the future of Judaism.

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Register New Student

New Student Registration 2026/2027
Please fill out a separate form for each child.

If you have any questions, you can call Pessi Levy at 706-829-8099 or email cjchabad@gmail.com.
Full Name*
First Name Last Name
Hebrew Name*
Birth Date*

Month Day Year
School*
Grade entering*
Previous Jewish Education

Address*

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

Allergies*

YesNo
If yes, please specify:
List name(s) of those (other than parents) authorized to pick up this child:*
I give permission to take photographs and / or video of my child. I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the Judea Kids Club's aims.
Digital signature:*
Parents Information
Father's Name*
First Name Last Name
Father's Hebrew Name
Father's Cell*

Area Code Phone Number
Father's E-mail*
Mother's Name*
First Name Last Name
Mother's Hebrew Name
Mother's Cell*

Area Code Phone Number
Mother's E-mail*
Is the mother Jewish?*

YesNo
Are there any conversion in the family?*

YesNo
If yes, please explain:
Payment and Tuition
Yearly tuition: $750

Early-bird discount: $650 (if registered before August 1)

Each additional child in the family: $550

Due today: $50 deposit (which will be applied to tuition)

(If you need a payment plan or you feel that you need a scholarship, please call us. No one will be turned away for lack of funds.)
Payment options:* To be charged to credit card on file

Payment in full on September 13 equal payment on September 1, December 1 and March 1I have spoken to the office regarding alternative payment plan
Registration Deposit

$50

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

I would like to receive news and updates by email
How did you hear about us?*
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Educate Your Child... Educate a Generation