Winter Mini-Camp - Form - Beth David Congregation

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Winter Mini-Camp

Parent First Name

Parent Last Name

Email

Cell Phone Number

Child 1 Name

Child 1 Grade/Age

Please share any allergies or special details our staff should know about Child 1.

Child 2 Name

Child 2 Grade/Age

Please share any allergies or special details our staff should know about Child 2.

Child 3 Name

Child 3 Grade/Age

Please share any allergies or special details our staff should know about Child 3.

* Emergency Contact 1

* Phone Number

* Emergency Contact 2

* Phone Number

Member Fees - $65 per day

Dec. 21

Dec. 22

Dec. 23

Dec. 24

Dec. 28

Dec. 29

Dec. 30

Non-Member Fees - $80 per day

Dec, 21

Dec. 22

Dec. 23

Dec. 24

Dec. 28

Dec. 29

Dec. 30

Total

Thu, April 15 2021 3 Iyyar 5781

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Beth David Congregation

2625 SW 3rd Ave Miami, FL 33129

(305) 854-3911 info@bethdavidmiami.org

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