Click here if you are ONLY registering for CKids After School Program. Have you ever registered your child(ren) for CKids Hebrew School before?* YesNo Parent's Info Mother's Name* First Name Last Name Hebrew Name If available Cell* Area Code Phone Number I have Whatsapp Messenger Service E-mail* Father's Name First Name Last Name Hebrew Name If available Cell Area Code Phone Number I have Whatsapp Messenger Service E-mail Home Phone Number Area Code Phone Number Address Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Are the natural father, mother and maternal grandmother of the child Jewish?* YesNo Have there been any conversions or adoptions in the family?* YesNo Did someone refer you? How did you find out about our program? Child's Info For how many child/children 1 Child's Name* First Name Last Name 1 Hebrew Name If available 1 Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day202020192018201720162015201420132012201120102009200820072006200520042003200220012000 Year 1 Grade Entering 1 School Attending 1 Previous Jewish Education? 1 Hebrew reading proficiency NoneSomewhatWell 1 Any special learning, behavioral needs or any family or living issues? 1 Additional Comments 2 Child's Name* First Name Last Name 2 Hebrew Name If available 2 Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day202020192018201720162015201420132012201120102009200820072006200520042003200220012000 Year 2 Grade Entering 2 School Attending 2 Previous Jewish Education? 2 Hebrew reading proficiency NoneSomewhatWell 2 Any special learning, behavioral needs or any family or living issues? 2 Additional Comments Emergency Information & Terms In the rare case that there is an emergency and we cannot reach either parent, please let us know who we can contact. Emergency Contact 1 First Name Last Name Home Area Code Phone Number Cell Area Code Phone Number Emergency Contact 2 First Name Last Name Home Area Code Phone Number Cell Area Code Phone Number Doctor's Name First Name Last Name Doctor's Number Area Code Phone Number Allergies or other Medical Condition What is your preference for reminder messaging? iMessage/textWhatsapp Pick-up Authorization List name(s) of those, other than parents, who are authorized to pick up your child(ren) from school:* Agreement As parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Ckids Hebrew School/After School/Chabad of Rancho Mirage to hospitalize or secure treatment for my child. This includes all medical transportation, medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures which may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. I further agree to pay all charges for that care and/or treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency. I allow my child to be photographed and for the photos to be used in print, video and digital media. I hereby give permission for my child to attend all field trips and outings sponsored by CKids Hebrew School and After School. Agreement* I have read the terms and conditions as laid out above and accept. CKids Sunday Program* I hereby register my child(ren) for the CKids Sunday program. CKids After School Program I hereby register my child(ren) for the Ckids After School program. Pricing options and choice of days will appear once you select a payment option CKids After School Program Pricing options and choice of days will appear once you select a payment option Choose Payment Option* Entire Year Registration3 Installments (September, December, March) Please Select Desired Program* Reflects discount of 10% until July 15 1 Day per Week - $612/year2 Days per Week - $1,071/year3 Days per Week - $1,440/year4-Day Program (Mon-Thurs) - $1,652/year 2 Please Select Desired Program* Reflects discount of 10% until July 15 1 Day per Week - $578/year2 Days per Week - $1,012/year3 Days per Week - $1,360/year4-Day Program (Mon-Thurs) - $1,561/year Please Select Desired Program* 3 installments due on Sep, Dec, March 1 Day per Week - $204/installment2 Days per Week - $357/installment3 Days per Week - $480/installment4-Day Program (Mon-Thurs) - $550.67/installment 2 Please Select Desired Program* 3 installments due on Sep, Dec, March 1 Day per Week - $192.67/installment2 Days per Week - $337.33/installment3 Days per Week - $453.33/installment4-Day Program (Mon-Thurs) - $530.33/installment Please Choose the Day(s)* MondayTuesdayWednesdayThursday Amount to Charge CKids I'm interested in finding out about tuition scholarship opportunities $50 down payment. Upon acceptance you will receive a contract. See Dates & Rates for total tuition fees. Registration - $50 Form Date Month Day Year Discount Code If any Discount - Levy Discount - Full Choose Payment Option* Includes $50 deposit and reflects discount of 25% Entire Year Registration - $900 Choose Payment Option* Includes $50 deposit and reflects discount of 25% 2nd Sibling Entire Year Registration - $840 Choose Payment Option* Includes $50 deposit and reflects discount of 20% Entire Year Registration - $9603 Installments - $328 Choose Payment Option* Includes $50 deposit and reflects discount of 20% 2nd Sibling Entire Year Registration - $9002nd Sibling in 3 Installments - $308 Choose Payment Option* Includes $50 deposit and reflects discount of 18% Entire Year Registration - $9843 Installments - $328 Choose Payment Option* Includes $50 deposit and reflects discount of 18% 2nd Sibling Entire Year Registration - $9242nd Sibling in 3 Installments - $308 Choose Payment Option* Includes $50 deposit and reflects discount of 10% until July 19, 2026 Entire Year Registration - $10803 Installments - $360 Choose Payment Option* Includes $50 deposit and reflects discount of 10% until July 19, 2026 2nd sibling Entire Year Registration - $10202nd Sibling in 3 Installments - $340 Choose Payment Option* Includes $50 deposit and reflects discount of 5% until August 3, 2026 Entire Year Registration - $11403 Installments - $380 Choose Payment Option* Includes $50 deposit and reflects discount of 5% until August 3, 2026 2nd sibling Entire Year Registration - $10802nd Sibling in 3 Installments - $360 Choose Payment Option* Entire Year Registration - $12003 Installments - $400 Choose Payment Option* 2nd sibling Entire Year Registration - $11402nd Sibling in 3 Installments - $380 Choose Payment Option* Includes $50 deposit and reflects discount of 17% Entire Year Registration - $8183 Installments - $273 Choose Payment Option* Includes $50 deposit and reflects discount of 17% 2nd sibling Entire Year Registration - $7722nd Sibling in 3 Installments - $258 Please Select Desired Program 4-Day Program (Mon-Thurs) - $54/week - $1,836/year1 Day per Week - $20/week - $680/year2 Days per Week - $35/week - $1,190/year3 Days per Week - $47/week - $1,600/year 2 Please Select Desired Program 4-Day Program (Mon-Thurs) - $51/week - $1,744/year1 Day per Week - $19/week - $646/year2 Days per Week - $33/week - $1,131/year3 Days per Week - $45/week - $1,520/year The next installment is due by September. Total $ USD $0.00 I would like to pay today:Full amount$50.00 minimum$ Payment Credit Card Check Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearCheck can be made payable and mailed to Chabad of Rancho Mirage • 72-295 Via Marta • Rancho Mirage, CA 92270Billing Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Submit Clear Form Should be Empty: This page uses TLS encryption to keep your data secure.
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