How many children are you registering for Summer Camp J 1 2 3 4
Camper 1 Camper Information
Legal Name*
First
Last
Chosen Name
First
Pronouns
Pronouns
Date of birth*
MM slash DD slash YYYY
Grade in Fall 2023* K 1 2 3 4 5 6 7 8 9 Early Childhood
Who does this child reside with?*
About your Camper Does this child receive support services (OT, PT, Special Education, etc.) or is 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)?* What type of group activities does your camper enjoy?*
Short Answer
What type of independent activities does your camper enjoy?*
Short Answer
What do big emotions look like in your camper?*
Short Answer
How can Camp J best support your camper during a big emotion?*
Short Answer
Is there any other information you would like Camp J to know about your camper?
Short Answer
Camp registration information Camp Type* Shalom (rising K-2) Giborim (rising 3-5) Camp Tiyul (rising 6-9) Early Childhood Camp (Yeladim / 3yrs by Sep 1, 2023) Early Childhood Camp (Chaverim / 4yrs by Sep 1, 2023)
Shalom Giborim Tiyul Camper Days & Hours (Member/Guest Pricing) *Early Childhood Camp Only* Fill out if you have a 3 or 4 year old camper in Early Childhood. Member price/Guest price
Camper Weeks: Select which weeks you want to register this camper for.* *No camp on Monday, May 29 (Memorial Day), or Tuesday, July 4 (Independence Day)
**Week 10 is shortened to account for the start of the school year and meet your teacher days
Camper 2 Camper Information
Legal Name*
First
Last
Chosen Name
First
Pronouns
Pronouns
Date of birth*
MM slash DD slash YYYY
Grade in Fall 2023* K 1 2 3 4 5 6 7 8 9 Early Childhood
Who does this child reside with?*
About your Camper Does this child receive support services (OT, PT, Special Education, etc.) or is 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)?* What type of group activities does your camper enjoy?*
Short Answer
What type of independent activities does your camper enjoy?*
Short Answer
What do big emotions look like in your camper?*
Short Answer
How can Camp J best support your camper during a big emotion?*
Short Answer
Is there any other information you would like Camp J to know about your camper?
Short Answer
Camp registration information Camp Type 2* Shalom (rising K-2) Giborim (rising 3-5) Camp Tiyul (rising 6-9) Early Childhood Camp (Yeladim / 3yrs by Sep 1, 2023) Early Childhood Camp (Chaverim / 4yrs by Sep 1, 2023)
Shalom Giborim Tiyul Camper Days & Hours (Member/Guest Pricing) *Early Childhood Camp Only* Fill out if you have a 3 or 4 year old camper in Early Childhood. Member price/Guest price
Camper Weeks: Select which weeks you want to register this camper for.* *No camp on Monday, May 29 (Memorial Day), or Tuesday, July 4 (Independence Day)
**Week 10 is shortened to account for the start of the school year and meet your teacher days
Camper 3 Camper Information
Legal Name*
First
Last
Chosen Name
First
Pronouns
Pronouns
Date of birth*
MM slash DD slash YYYY
Grade in Fall 2023* K 1 2 3 4 5 6 7 8 9 Early Childhood
Who does this child reside with?*
About your Camper Does this child receive support services (OT, PT, Special Education, etc.) or is a client with DDD?* Does your camper have any sensory sensitivities (ex: sounds, lights, textures, smells, etc)?* What type of group activities does your camper enjoy?*
Short Answer
What type of independent activities does your camper enjoy?*
Short Answer
What do big emotions look like in your camper?*
Short Answer
How can Camp J best support your camper during a big emotion?*
Short Answer
Is there any other information you would like Camp J to know about your camper?
Short Answer
Camp registration information Camp Type 3* Shalom (rising K-2) Giborim (rising 3-5) Camp Tiyul (rising 6-9) Early Childhood Camp (Yeladim / 3yrs by Sep 1, 2023) Early Childhood Camp (Chaverim / 4yrs by Sep 1, 2023)
Shalom Giborim Tiyul Camper Days & Hours (Member/Guest Pricing) *Early Childhood Camp Only* Fill out if you have a 3 or 4 year old camper in Early Childhood. Member price/Guest price
Camper Weeks: Select which weeks you want to register this camper for.* *No camp on Monday, May 29 (Memorial Day), or Tuesday, July 4 (Independence Day)
**Week 10 is shortened to account for the start of the school year and meet your teacher days
Camper 4 Camper Information
Legal Name*
First
Last
Chosen Name
First
Pronouns
Pronouns
Date of birth*
MM slash DD slash YYYY
Grade in Fall 2023* K 1 2 3 4 5 6 7 8 9 Early Childhood
Who does this child reside with?*
About your Camper Does this child receive support services (OT, PT, Special Education, etc.) or is 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)?* What type of group activities does your camper enjoy?*
Short Answer
What type of independent activities does your camper enjoy?*
Short Answer
What do big emotions look like in your camper?*
Short Answer
How can Camp J best support your camper during a big emotion?*
Short Answer
Is there any other information you would like Camp J to know about your camper?
Short Answer
Camp registration information Camp Type 4* Shalom (rising K-2) Giborim (rising 3-5) Camp Tiyul (rising 6-9) Early Childhood Camp (Yeladim / 3yrs by Sep 1, 2023) Early Childhood Camp (Chaverim / 4yrs by Sep 1, 2023)
Shalom Giborim Tiyul Camper Days & Hours (Member/Guest Pricing) *Early Childhood Camp Only* Fill out if you have a 3 or 4 year old camper in Early Childhood. Member price/Guest price
Camper Weeks: Select which weeks you want to register this camper for.* *No camp on Monday, May 29 (Memorial Day), or Tuesday, July 4 (Independence Day)
**Week 10 is shortened to account for the start of the school year and meet your teacher days