Jewish Kids Club Registration Child ProfileName* First Last Hebrew Name* Date of Birth* MM slash DD slash YYYY School* Grade* Age*Approximate Time of Arrival* To determine your child's Jewish birthday, what time of day (approx.) was your child born?* Hours : Minutes AM PM HiddenI am enrolling my child for:* Mondays Wednesday I am enrolling my child for:* Select All Fall Winter Spring Family InformationMother's Name* First Last Mother's Email* Phone*Father's Name* First Last Father's Email* Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Would you be interested in school pick-up?* YES NO Persons authorized to pick-up my child Emergency InformationEmergency Contact 1* First Last Phone*Emergency Contact 2* First Last Phone*Physician* First Last Physician's Phone Number*CONFIDENTIAL:*Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed. HiddenDates & RatesTuition 2021-22 Financial Aid/Tuition Assistance – Contact Leah@JewishPreschool.org 2 days/week: $24/day 1 day/week: $25/day Current CCJP Student (enrolled in Late Care) = $10/day (5:00 PM – 6:00 PM) 10% discount for former CCJP students and current students ages 5+ not enrolled in late care $100 discount for families who enroll for all 3 semesters and submit payment in full by Sept. 6th. Winter Semester (Jan-March) Mondays: $275 Wednesdays: $325 Mondays & Wednesdays: $576 Spring Semester (April-June) Mondays: $175 Wednesdays: $200 Mondays & Wednesdays: $360 TuitionTuition can be paid by cash, check, money order, or bank transfer. Please make your check payable to: Center City Jewish Preschool 527 Lombard Street Philadelphia, PA 19147PhoneThis field is for validation purposes and should be left unchanged.