Online Registration is now CLOSED! Please Text Hadassah 516-458-3694about availabilityParent InformationParent NameFirst NameLast NameCell Phone NumberArea CodePhone NumberE-mailI would like to receive news and updates by emailChild #1 InformationChild #1 NameFirst NameLast NameBirth Date1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearSchoolGradeDays Attendingif your child will be attending the entire week please only choose the LAST optionTuesday - Bounce SyossetWednesday - LEGO LandThursday - K & 1st - Long Island Gymnastics l 2nd - 8th Snow TubingFriday - BowlingTuesday - FridayComments - Please list any Allergies or Services Child ReceivesChild #2 InformationChild #2 NameFirst NameLast NameBirth Date1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearSchoolGradeDays Attendingif your child will be attending the entire week please only choose the LAST optionTuesdayWednesdayThursday - K & 1st - Long Island Gymnastics l 2nd - 8th Snow TubingFridayTuesday - FridayComments - Please list any Allergies or Services Child ReceivesAs the parent(s) or legal guardian of the above child/ren, I/we authorize any adult acting on behalf of Chabad of the Five Towns to hospitalize or secure treatment for my child/ren, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Winter Camp personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child/ren to participate in all camp activities, join in camp trips on and beyond camp properties and allow my child/ren to be photographed while participating in Chabad Winter Camp activities and that these pictures may be used for marketing purposes.I AcceptSubmitShould be Empty: This page uses TLS encryption to keep your data secure.