Registration forms 2018-02-07T21:22:47+00:00

New Website

coming soon

Registration now available for Ruach & Penina

Register for Ruach
Register for Penina

Ruach Registration

*Required Fields


Camper 1

Duration*

Whole SummerFirst TripSecond TripOther

Bunk Request




Camper 2

Duration

Whole SummerFirst TripSecond TripOther

Bunk Request




Camper 3

Duration

Whole SummerFirst TripSecond TripOther

Bunk Request




Camper 4

Duration

Whole SummerFirst TripSecond TripOther

Bunk Request






Parents

Parental Status

MarriedDivorcedDeceased FatherDeceased Mother


Father's Name*
RabbiDr.Mr.
Father's cell*
Father's Business Telephone
Father's Email Address*
Father's Address*


Mother's Name*
Mrs.MsDr.
Mother's cell*
Mother's Business Telephone
Mother's Email address*
Mother's Address*


Home telephone*
Address*




Emergency Contacts

contact 1


contact 2


Doctor




Bus Information

A.M. Exact Pickup Location

P.M. Exact Pickup Location

No Bus Transportation


Notes


Contract

In the event of a medical emergency I hereby give authority to Ruach Day Camp staff to obtain necessary medical treatment for my child/children:

Ruach Daycamp and their staff shall be held harmless from any and all liabilities arising from emergency.

I understand that any belongings left at the end of the summer may be donated to tzedaka.

The camp administration reserves the discretionary right to require the withdrawal of any camper for disciplinary or educational reasons. I will incur a minimum of $100 plus pro-rated charge for amounts of days in camp.

I will be held liable for any and all damages incurred by my child(ren).

Tuition must be paid in full prior to June 1st. Any outstanding balance will terminate my child's admission to camp

I fully understand that I will receive a full refund if I cancel before June 1st. I will receive no refunds for any other absences or cancellations.

It is not the camp's responsibility to collect from other sources, scholarships, sponsorships, or vouchers, beyond normal billing.

I agree to send my children on all camp trips with transportation provided.


I hereby certify that the information given in this application is complete and true, and agree to all the points stated above.


Deposit

Please enter your credit card in order for us to hold a spot for you child(ren).

Deposit amount:
$300 deposit per child for full summer
$150 deposit per child for half a summer
Your credit card will be charged within a few days of submission.

Payments

The balance for the summer is due in full by June 1st

Pricing


Total due after deposit:*

Please choose one from the following*:

Please charge entire amount upon receipt of applicationBalance will be paid by check/cashEnter credit card payment plan

Credit Card for Payments

Use same credit card written aboveEnter new credit card




Penina Registration

*Required Fields


Camper 1

Duration*

Whole SummerFirst TripSecond TripOther

Early Drop Off/Late Stay

Early Drop Off 8:00-9:00 AM (Full Summer additional $200, Half Summer additional $100)Late Stay 4:00 - 5:00 PM (Full Summer additional $200, Half Summer additional $100)Early Drop Off and Late Stay (Full Summer additional $350, Half Summer additional $175)

Bunk Request




Camper 2

Duration

Whole SummerFirst TripSecond TripOther

Early Drop Off/Late Stay

Early Drop Off 8:00-9:00 AM (Full Summer additional $200, Half Summer additional $100)Late Stay 4:00 - 5:00 PM (Full Summer additional $200, Half Summer additional $100)Early Drop Off and Late Stay (Full Summer additional $350, Half Summer additional $175)

Bunk Request




Camper 3

Duration

Whole SummerFirst TripSecond TripOther

Early Drop Off/Late Stay

Early Drop Off 8:00-9:00 AM (Full Summer additional $200, Half Summer additional $100)Late Stay 4:00 - 5:00 PM (Full Summer additional $200, Half Summer additional $100)Early Drop Off and Late Stay (Full Summer additional $350, Half Summer additional $175)

Bunk Request




Camper 4

Duration

Whole SummerFirst TripSecond TripOther

Early Drop Off/Late Stay

Early Drop Off 8:00-9:00 AM (Full Summer additional $200, Half Summer additional $100)Late Stay 4:00 - 5:00 PM (Full Summer additional $200, Half Summer additional $100)Early Drop Off and Late Stay (Full Summer additional $350, Half Summer additional $175)

Bunk Request






Parents

Parental Status

MarriedDivorcedDeceased FatherDeceased Mother


Father's Name*
RabbiDr.Mr.
Father's cell*
Father's Business Telephone
Father's Email Address*
Father's Address*


Mother's Name*
Mrs.MsDr.
Mother's cell*
Mother's Business Telephone
Mother's Email address*
Mother's Address*


Home telephone*
Address*




Emergency Contacts

contact 1


contact 2


Doctor




Bus Information

A.M. Exact Pickup Location

P.M. Exact Pickup Location

No Bus Transportation


Notes


Contract

In the event of a medical emergency I hereby give authority to Machane Penina staff to obtain necessary medical treatment for my child/children:

Machane Penina and their staff shall be held harmless from any and all liabilities arising from emergency.

I understand that any belongings left at the end of the summer may be donated to tzedaka.

The camp administration reserves the discretionary right to require the withdrawal of any camper for disciplinary or educational reasons. I will incur a minimum of $100 plus pro-rated charge for amounts of days in camp.

I will be held liable for any and all damages incurred by my child(ren).

Tuition must be paid in full prior to June 1st. Any outstanding balance will terminate my child's admission to camp

I fully understand that I will receive a full refund if I cancel before June 1st. I will receive no refunds for any other absences or cancellations.

It is not the camp's responsibility to collect from other sources, scholarships, sponsorships, or vouchers, beyond normal billing.

I agree to send my children on all camp trips with transportation provided.


I hereby certify that the information given in this application is complete and true, and agree to all the points stated above.


Deposit

Please enter your credit card in order for us to hold a spot for you child(ren).

Deposit amount:
$300 deposit per child for full summer
$150 deposit per child for half a summer
Your credit card will be charged within a few days of submission.

Payments

The balance for the summer is due in full by June 1st

Pricing


Total due after deposit:*

Please choose one from the following*:

Please charge entire amount upon receipt of applicationBalance will be paid by check/cashEnter credit card payment plan

Credit Card for Payments

Use same credit card written aboveEnter new credit card