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Celebrate Pesach 5783
Winter Mini-Camp
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Parent First Name
Parent Last Name
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Child 1 Name
Child 1 Grade/Age
Select Grade/Age
18-24 months
2-3 years
4-5 years (pre-K)
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1st Grade
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3rd Grade
4th Grade
5th Grade
Please share any allergies or special details our staff should know about Child 1.
Child 2 Name
Child 2 Grade/Age
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18-24 months
2-3 years
4-5 years (pre-K)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Please share any allergies or special details our staff should know about Child 2.
Child 3 Name
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Select Grade/Age
18-24 months
2-3 years
4-5 years (pre-K)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
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Emergency Contact 1
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Emergency Contact 2
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Member Fees - $65 per day
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Dec. 20
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Non-Member Fees - $80 per day
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Total
Thu, March 28 2024 18 Adar II 5784