Legal Name *
First
Last
Chosen Name
First
Pronouns
Pronouns
About your Camper Does your camper receive support services (OT, PT, Special Education, etc.) ? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Is your camper a client with DDD? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Does your camper have any sensory sensitivities (ex: sounds, lights, textures, smells, etc)? *
Camp registration information Yeladim (Children) Chaverim (Friends) Noar (Youth) Shalom (Peace)​ Giborim (Heroes) Tiyul (Trip) Nisayon (Experience) Nisayon Sessions * Camper Weeks: Select which weeks you want to register this camper for. * *NO CAMP ON MON, MAY 26 (MEMORIAL DAY) OR FRI, JULY 4 (INDEPENDENCE DAY)
Legal Name *
First
Last
Chosen Name
First
Pronouns
Pronouns
About your Camper Does your camper receive support services (OT, PT, Special Education, etc.)? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Is your camper a client with DDD? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Does your camper have any sensory sensitivities (ex: sounds, lights, textures, smells, etc)? *
Camp registration information Chaverim (Friends) Yeladim (Children) Noar (Youth) Shalom (Peace)​ Giborim (Heroes) Tiyul (Trip) Nisayon (Experience) Nisayon Sessions * Camper Weeks: Select which weeks you want to register this camper for. * *NO CAMP ON MON, MAY 26 (MEMORIAL DAY) OR FRI, JULY 4 (INDEPENDENCE DAY)
Legal Name *
First
Last
Chosen Name
First
Pronouns
Pronouns
About your Camper Does your camper receive support services (OT, PT, Special Education, etc.)? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Is your camper a client with DDD? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Does your camper have any sensory sensitivities (ex: sounds, lights, textures, smells, etc)? *
Camp registration information Yeladim (Children) Chaverim (Friends) Noar (Youth) Shalom (Peace)​ Giborim (Heroes) Tiyul (Trip) Nisayon (Experience) Nisayon Sessions * Camper Weeks: Select which weeks you want to register this camper for. * *NO CAMP ON MON, MAY 26 (MEMORIAL DAY) OR FRI, JULY 4 (INDEPENDENCE DAY)
Legal Name *
First
Last
Chosen Name
First
Pronouns
Pronouns
About your Camper Does your camper receive support services (OT, PT, Special Education, etc.)? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Is your camper a client with DDD? * *If checked “yes, you will be contacted regarding your child’s specific needs to determine eligibility and to develop support strategies to ensure his or her success at camp. Our goal is to be inclusive, proactive, and supportive
Does your camper have any sensory sensitivities (ex: sounds, lights, textures, smells, etc)? *
Camp registration information Chaverim (Friendship) Yeladim (Children) Noar (Youth) Shalom (Peace)​ Giborim (Heroes) Tiyul (Trip) Nisayon (Experience) Nisayon Sessions * Camper Weeks: Select which weeks you want to register this camper for. * *NO CAMP ON MON, MAY 26 (MEMORIAL DAY) OR FRI, JULY 4 (INDEPENDENCE DAY)
Family Info Grown-Up's name *
First
Last
Grown-Up's Address *
Grown-Up's name
First
Last
Grown-Up's Address
Are you applying for scholarship? * For scholarships, visit https://tucsonjcc.org/financial-assistance/ NOTE: Your scholarship will not be applied if you do not submit a separate scholarship application!
Scholarships are available for members only.
Are you receiving DES for camp? * Are you a deployed military family? * Deployed military families receive a 5% discount at time of registration.
Credit Card Name on Card *
First
Last
Billing Address *
Note: The card will not be charged until their camper is actively registered by Director of Camping Services
Check
Important Policies Digital Signature *
First
Last
I hereby state that the information provided on this application is complete and correct to the best of my knowledge. I understand that I am responsible for paying all balances by the agreed upon dates.