HEBREW WIZARDS ENROLLMENT

Tuition includes all handouts, snacks and activities. To secure your enrollment, please pay full amount for family membership and/or tuition.

Please make checks payable to:

Hebrew Wizards, Inc.
C/O Rabbi Deborah Salomon
130 Cummings Point Road
Stamford, CT 06902

Hebrew Wizards Family Application 2017-2018
Contact Person's First Name  
Contact Person's Last Name  
Contact Person's E-mail Address  
Contact Person's Phone Number  
See below for Family Membership & Tuition Fees

Parent's/Guardian's Details
Parent / Guardian 1
First Name  
Last Name  
E-mail Address  
Cell Phone  
Address  
City  
State  
Zip Code  
Parent / Guardian 2
First Name  
Last Name  
E-mail Address  
Cell Phone  
Address  
City  
State  
Zip Code  
Emergency Contact
First Name  
Last Name  
E-mail Address  
Cell Phone  
Address  
City  
State  
Zip Code  

Child Details
Child 1
Class (mark with an X)       Little-Wizards (Ages 2-3)
        Mini-Wizards (Ages 3-5)
        Wizards I (Ages 6-7)
        Wizards II (Ages 8-12)
        Mitzvah Wizards (Ages 12-13)
        Teen Wizards (Ages 13+)
        Better Together Teen

First Name  
Last Name  
Date of birth  
Which school does this child attend?  
What grade is your child in at school?  

Child 2
Class (mark with an X)       Little-Wizards (Ages 2-3)
        Mini-Wizards (Ages 3-5)
        Wizards I (Ages 6-7)
        Wizards II (Ages 8-12)
        Mitzvah Wizards (Ages 12-13)
        Teen Wizards (Ages 13+)
        Better Together Teen

First Name  
Last Name  
Date of birth  
Which school does this child attend?  

Child 3
Class (mark with an X)       Little-Wizards (Ages 2-3)
        Mini-Wizards (Ages 3-5)
        Wizards I (Ages 6-7)
        Wizards II (Ages 8-12)
        Mitzvah Wizards (Ages 12-13)
        Teen Wizards (Ages 13+)
        Better Together Teen

First Name  
Last Name  
Date of birth  
Which school does this child attend?  

Child 4
Class (mark with an X)       Little-Wizards (Ages 2-3)
        Mini-Wizards (Ages 3-5)
        Wizards I (Ages 6-7)
        Wizards II (Ages 8-12)
        Mitzvah Wizards (Ages 12-13)
        Teen Wizards (Ages 13+)
        Better Together Teen

First Name  
Last Name  
Date of birth  
Which school does this child attend?  


Sponsorship
I would like to sponsor the Wizards Board in the amount of     $250   $500   $750   $1000
Or enter amount here   $

Comments / Special Instructions / Feedback
 
I am a new family and I have been referred by:

Signed: Date:

FAMILY MEMBERSHIP & TUITION FEES Annual Fee
Family Membership & 1 child (12 and under) $3,000
Family Membership & 2 children (12 and under) $4,000
Family Membership & 3 children (12 and under) $5,000
Family Membership & 1 B Mitzvah student (siblings 11 and under are reduced to $1000 each) $6,000
Family Membership - Teens $500
Better Together Teen $500

* Mitzvah Wizards 2017 includes 10 hours of private tutoring at your home, all B Mitzvah materials, sound system and complete service with qualified professionals.