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Register Online!

Register Online!

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Online Registration!

Please fill out the form below carefully. When you press submit, this form will be sent to our administration office.

Note: Please use a separate form for each child.

Camper/Parent Information
Name
  First
Middle Last Hebrew Name
Address
  Street
City State
Zip
Date of Birth
       Boy     Girl
     
Contact Info
  Phone
Email
   Session:     Full      1st      2nd
                         
Schools
  School
Age:
Grade completed 6/10:
Child's Mother
  Name
Hebrew Name Work Phone Cell
Child's Father
  Name
Hebrew Name Work Phone Cell
Marital Status
   

Child resides with:

   
Persons authorized to pick up camper
 
#1 Name  Phone Number

#2 Name 
Phone Number

#3 Name  Phone Number
#4 Name  Phone Number
Emergency Contact Info1
  Name
Phone Relationship  
Emergency Contact Info #21
  Name
Phone Relationship  
           
Medical/Health Information
Family Physician
Name
Phone

 

 
Medication Medication that your child takes regularly:
Will this medication need to be dispensed at camp?
   Yes       No

If yes please explain

Health Issues
Special dietary needs or restrictions:
Any recent surgery or serious illness:
List any allergies (food or medication)
Health Issues
Is your child prone to:
Ear infection             Sinus infection
 Other please explain
 My child has received all the shots needed for his age according to the Finnish Health Care.
 
 
General Information:
Camper Info
Camper’s strong likes and dislikes: Camper makes friends:
 Easily
 Fairly well
 With difficulty

How does your child feel about going to camp this summer?

What is the most important thing that you would like us to know about your child?

T-Shirt Info

I would like to buy  T Shirts at 7.00 a T Shirt T-shirt size    6-8    10-12    14-16
Adult S  Adult M   Adult L   2
Payment Information:

Payment type

American Express   Visa   Master Card     Nordea (See account info. here)  

Credit Card Info

Number
Expiration Date
Amount to charge:   
Comments:
         




 

1 Please note: these numbers are needed in event of an emergency.
2 Actual shirt sizes run small (e.g. if you need a 10-12 size order 14-16 etc.)

 

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