Winter Camp!

Winter camp is for children in the local district schools & Brandeis
Parent Information
Parent Name
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Child #1 Information
Child #1 Name
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Days Attendingif your child will be attending the entire week please only choose the LAST option
MondayTuesdayWednesdayThursdayFridayMonday - Friday
Comments - Please list any Allergies or Services Child Receives
Child #2 Information
Child #2 Name
First NameLast Name
Birth Date
MonthDayYear
School
Grade
Days Attendingif your child will be attending the entire week please only choose the LAST option
MondayTuesdayWednesdayThursdayFridayMonday - Friday
Comments - Please list any Allergies or Services Child Receives
As 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.
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Winter camp is for children in the local district schools & Brandeis

Parent Information

Child #1 Information

Child #2 Information

Payment