AFTER SCHOOL REGISTRATION | Chabad of S. Clara

Use tab to navigate through the menu items.

To register, please take the time to fill out the information below.

Student First Name

Birthday

Age

Last Name

Gender

Grade Entering in 2021

Mothers First Name

Mothers Email

Father First Name

Fathers Email

Home Address

Mother Last Name

Mothers Cell Phone

Father Last Name

Fathers Cell Phone

City

Home Phone

Please share a friend or relative who can be contacted in case of emergency when both parents are unavailable.

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

CONTACT US

Centrally located In the Heart of Santa Clara.

Contact Us for Address