Registration

How many children are you registering?
- 1
- 2
- 3
Child 1 Name*
First Last
Hebrew Name
DOB*
Date Format: MM slash DD slash YYYY
Age*
School*
Current Grade*
Second Child
Child 2 Name*
First Last
Hebrew Name
DOB*
Date Format: MM slash DD slash YYYY
Age*
School*
Current Grade*
Third Child
Child 3 Name*
First Last
Hebrew Name
DOB*
Date Format: MM slash DD slash YYYY
Age*
School*
Current Grade*
Parent Information
Father's Name*
First Last
Father's Cell*
Father's Email*
Mother's Name*
First Last
Mother's Cell*
Mother's Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of?*
- Yes
- No
Will you be requesting a scholarship? This should not deter any parents from requesting a scholarship. We ask this question for informational purposes.*
- Yes
- No
Please describe them and indicate special precautions or care needed.
Upon submitting this form, you will be redirected to a payment page to submit a $150 non-refundable registration fee. This will be applied to your final camp tuition fee.
We look forward to a fantastic summer camp season!

Additional forms (medical, transportation…) will be required upon acceptance.

If you’re requesting a scholarship, an email will be sent to you with available scholarship opportunities.

Second Child