JFX Winter Camp - Form - Jewish Family Experience

* Number of children registering

Camper 1 General Information

* Child's full name

Does your child have a preferred name or nickname? If so, list it here

* Where does your child go to school?

* Date of birth

* Age

* Allergies

ATTENDANCE. What weeks would you like this child to attend

Week 1- December 22-26Week 2-December 29-January 2

Camper 2 General Information

Child's full name

Does your child have a preferred name or nickname? If so, list it here

Where does your child go to school?

Date of birth

Age

Allergies

ATTENDANCE. What weeks would you like this child to attend

Week 1-December 22-26Week 2-December 29-January 2

Camper 3 General Information

Child's full name

Does your child have a preferred name or nickname? If so, list it here

Where does your child go to school?

Date of birth

Age

Allergies

ATTENDANCE. What weeks would you like this child to attend

Week 1-December 22-26Week 2-December 29-January 2

Family Information

* Home address

* City

* State

* ZIP code

* Best primary contact email address

* Best primary contact phone number

PARENTS' NAMES AND CONTACT INFORMATION

* First name

* Last name

Phone number

Email address

First name

Last name

Phone number

Email address

Emergency Contact Number 1 - In case parents can't be reached

* First name

* Last name

* Phone number

* Relationship to child(ren)

Emergency Contact Number 2 - In case parents can't be reached

First name

Last name

Phone number

Relationship to child(ren)

* Name of child(ren) Pediatrician

* Phone number of Pediatrician

* Name of child(ren) dentist

* Phone number of dentist

What would you want your child to experience with us this winter?

Terms and Conditions

1. Tuition fees & refund policy: Registration is for the week, and there is to be no prorating per day. The tuition fees are due by the first day of camp 12/22/2025. No refunds.

2. Emergency care: In the event of an emergency, serious illness, or accident, Jewish Family Experience (JFX) has my permission to arrange for any necessary first-aid or care by a licensed physician for my child/ren while he/she is attending camp.

3. Images: JFX is hereby granted permission to use any individual or group camp photos and/or videos showing our children involved in camp activities.

4. Damages: As parents or guardians, we agree to be responsible for any loss, damage or destruction by our child to any property of JFX or to any property for which the camp is liable or chargeable.

* I have read and accept all of the terms and conditions set forth in this registration form.

I have read and accept all of the terms and conditions set forth in this registration form.

* Electronic signature

* Today's date

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