Camp Registration

Address*

Phone Number*
Area CodePhone Number
Mother Information:
Full Name*
First NameLast Name
Hebrew Name*
Cell Number*
Area CodePhone Number
E-mail*
Mother is:*
Mother is:*
Father Information:
Full Name*
First NameLast Name
Hebrew Name*
E-mail*
Cell Number*
Area CodePhone Number
Father is:*
Father is:*
Emergency Contact:
Full Name*
First NameLast Name
Phone Number*
Area CodePhone Number
Relationship*
Physician Information:
Full Name*
First NameLast Name
Phone Number*
Area CodePhone Number
Child Age Group:
Please select one
*
3-5 years old6-8 years old9-11 years old
Sessions - Summer 5778/2018
Camp will be July, 1 - July, 26
Please check all that apply*
Full SessionJuly 1 - 5July 8 - 12July 15 - 19July 22 - 26
All forms must be completed and submitted before your child begins camp.

Cost per week is: $125
Lunch can be provided for an additional $25 per week.

All trips and activities are included in camp tuition.

Scholarships are available. No child will be turned away due to lack of funds. To apply for a scholarship, please contact us at: Rabbi@ChabadOfWilmington.org
Full session w/o lunch
$500
Full session with lunch
$600
Weekly selection w/o lunch
$125$250$375
Weekly selection with lunch
$150$300$450
Total
$0.00

Payment

Credit Card Check

Postal / Zip Code

Country

I have read the camp brochure and application form and agree to the terms stated.

I give my child permission to attend all trips, and receive medical care in the case of emergency.
Electronic Signature*
Should be Empty:

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Camp Updates

Stay tuned for summer 2020 info!