Printed from ChabadofBensonhurst.com
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Register

  • Kivun Registration Form 2020-21

  • Parents' Information

  • Child's Information

  • Emergency Information

  • Authorization

  • I hereby give permission for my child to be transported to and from field trips, and to participate in them in all Kivun activities. I understand that during the course of Kivun my child can be hurt. I accept the risk of possible injury and authorize any member of the Chabad of the West Side staff to render any necessary first aid. Furthermore, in an emergency case, I hereby authorize Chana hertz or another staff member to have my child taken care of by a physcian or other medical person in any way the situation calls for. 

  • I give permission to Chabad of Bensonhurst and Kivun, and those authorized by Chabad, to take photographs and to make recordings of my children and my family, and to use them in original or modified form in all media now or hereafter known, with or without my name or information about me, for the promotion, public education, and/or fundraising activities of Chabad of Bensonhurst. 

  • Schedule and Payment Options

  • Sibling Discount: 10% sibling discount for 2nd and 3rd children in the same family

    Ambassador Discount: Get another family to register for Kivun, you will get $50 off your tuition!  

    Payment:
    $300 for January 2021 - June 2021
    Deduct 10% of total for second and third child

    Scholarships Available - Please call 347.277.5040 

  • Credit Card
    Billing Address
  • Should be Empty:
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