Child's InfoName* First Last Hebrew Name* Gender* Male Female Birthdate* MM slash DD slash YYYY Mother's InfoName* First Last Hebrew Name* Occupation* Cell Phone* Email* Father's InfoFather's Name* First Last Hebrew Name* Occupation* Cell Phone* Email* Contact InfoHome Phone Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Family InfoIs the Mother of the child Jewish?* Yes No Is the Father of the child Jewish?* Yes No Are there any conversions in the family?* Yes No Does the child live with both natural parents?* Yes No Marital Status of Parents* Program Selection* All children must be fully toilet trained before camp begins. Program* 3 yr old group. (child must turn 3 before Oct. 1, 2024.) 4 yr old group. (child must turn 4 before Oct. 1, 2024.) Full Name* First Last How did you hear about us?* Δ
