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Camp Ruach Registration 2024
Please verify reCaptcha before submitting the form.
Tell us how you heard about us?
*
Current Synagogue Affiliation
Please Select One
Current Etz Chaim Member
Not a Member of Etz Chaim
If not currently a member, would you like to receive information about upcoming Etz Chaim activities?
Yes
No
Family Information
*
Parent Names
*
Home Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
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California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Hawaii
Idaho
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Indiana
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Louisiana
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Maryland
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New York
North Carolina
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Ohio
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Pennsylvania
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Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
*
Cell Phone Number
*
Additional Phone Number
*
Primary Email Address
Number of Preschool Children being Enrolled
Select One
1-child
2-child
3-child
There is a $75 non-refundable deposit per child for the summer to be applied to your camp tuition and must accompany the registration form.
Student Information and Program Selection
Enter the Number of Children 14-mths to Rising K Grade being Registered (same number as above)
0
1
2
3
*
Child's First Name
*
Child's Last Name
Nickname
*
Birthday
*
Gender
Please Select One
Female
Male
*
Age Group
Select One
14 mos - 23 mos (child must be walking in order to attend)
2 yr
3 yr
PreK
Rising K
Daily Schedule
- check which one applies
8:00 am - 5:00pm
8:00 am - 5:00pm
9:30 am - 1:30 pm
9:30 am - 1:30 pm
*
Weekly Schedule
Please Select One
5 Day Option
4 Day Option
3 Day Option
2 Day Option
Final availability of days will be determined by enrollment
Day Preferences
- check all that apply
Monday
Monday
Tuesday
Tuesday
Wednesday
Wednesday
Thursday
Thursday
Friday
Friday
Weeks of Camp
-
check all that apply
(Week 1) June 3 -June 7
(Week 1) June 3 -June 7
(Week 2) June 10 -June 14
(Week 2) June 10 -June 14
*Camp Closed June 12
(Week 3) June 17 - June 21
(Week 3) June 17 - June 21
*Camp Closed June 19
(Week 4) June 24 - June 28
(Week 4) June 24 - June 28
(Week 5) July 1 - July 5
(Week 5) July 1 - July 5
*Camp Closed July 4
(Week 6) July 8 - July 12
(Week 6) July 8 - July 12
(Week 7) July 15 - July 19
(Week 7) July 15 - July 19
(Week 8) July 22 - July 26
(Week 8) July 22 - July 26
In the box below please let us know any deviations you have from the schedule you marked. Ex: Wk 1 M/W/F & Wk 2 M-F
Disclaimer:
Registration and/or schedule changes received after May 1, 2024 will incur a $10 per week administrative fee.
All camp fees are due by the 1st of the month, unless other arrangements have been made. There will be NO REFUNDS
after May 1, 2024.
Please sign your name below stating you have read this disclaimer.
*
Signature for Disclaimer
TOTAL REGISTRATION FEE DUE
Sat, July 27 2024 21 Tammuz 5784