Camp Chabad Summer Camp Registration Form

What goals would you like to see your child accomplish during camp?

Bunk Placement: List other children (in same grade) with whom your child would like to be placed:

Parent's Information

Preferable email address for Camp Chabad communication *

Father

Mother

Father & Mother

Weeks attending Camp Chabad *

Week 1 - June 19 - June 23

Week 2 - June 26 - 30

Week 3 - July 3 - 7 (No Camp Tuesday July 4th)

Week 4 - July 10 - 14

Week 5 - July 17 - 21

Week 6 - July 24 - July 28 (No Camp Thursday July 27th Tisha B'av)

Before camp care (Minimum number of campers required)

8:00 AM - 9:30 AM ($40 a week)

After camp care (Minimum number of campers required)

3:30 PM - 5:00 PM ($70 a week)

Weeks - Before camp care *

Before care week 1 - June 19 - 23

Before care week 2 - June 26 - 30

Before care week 3 - July 3 - 7 (No camp Tuesday July 4th)

Before care week 4 - July 10 - 14

Before care week 5 - July 17 - 21

Before care week 6 - July 24 - 28 (No Camp Thursday July 27th Tisha B'av)

Weeks - After camp care *

After care week 1 - June 13 - 23

After care week 2 - June 26 - 30

After care week 3 - July 3 - 7 (No camp Tuesday July 4th)

After care week 4 - July 10 - 14

After care week 5 - July 17 - 21

After care week 6 - July 24 - 28 (No camp Thursday July 27th Tisha B'av)

Policy & Photo Release

Registration for programs is limited and will be filled on “first - come first - served” basis. Balance must be paid in full by May 19th, 2023. Cancellations received by May 19th, 2023 will be refunded 50%. No refunds will be credited for cancellations after June 1st 2023. Campers must be paid in full prior to any weeks they attend.

Policy *

I hereby give permission for my child to participate in all Camp Chabad activities and trips. I understand the camp’s fees and cancellation Policy.

Payment *

If I don’t make payment arrangement prior to June 1, 2023 my credit card on file will be charged the full balance due.

Photo Release

I also authorize Camp Chabad to have and use photographs, slides and videos of the person named on this application as needed for educational and public relations programs

Please consider making a donation to our
camp scholership fund to help a less fortunate child.

Camper Information

General Information

Parent's Information

Attendance

Kiddie Camp Options

Policy & Photo Release

Payment