Registration

CHILD'S INFORMATION:

Name*

First Last

Sex*

Male
Female

Age now*

How old will child be on 9/1/26?*

Date of Birth*

FAMILY INFORMATION:

Mother's Information

Mother's Name*

First Last

Jewish?*

Yes
No

If Yes, by:*

Birth
Choice

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Cell Phone*

Email*

Father's Information

Father's Name

First Last

Jewish?

Yes
No

If Yes, by:

Birth
Choice

Address

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone

Email

Child lives with*

Mother
Father
Both
Other

Parents or gaurdians are*

Married
Separated
Divorced
Single

Who has legal custody?*

Please send all Camp correspondence to:*

Mother
Father
Other

Previous programs attended?*

Is there any special situation or characteristic concerning your child that is important for the camp to be aware of?*

Ex; Intellectual| emotional | physical | developmental |

Select Schedule*

Whole Summer 8 week program FULL day Mon-Fri 9am -3pm $3,200
Whole Summer 8 week program HALF day: Mon-Fri 9am-12:30pm $2,640
Weekly FULL day $450 indicate below which week/s
Weekly HALF day $400 indicate below which week/s

Individual week/s registration;

If you would like to register for indivcidual weeks -please indicate the exact weeks you would like to reserve for. The office will confirm availability.

Registration of $100 and security fee of $250 are due upon registration.*

Credit Card on payment form. Due today

After submitting this form follow the link to the payment page

Lunch option*

Yes I would like camp lunch $330 whole summer
No I do not want lunch and will provide my own
I would like lunch for the individual week/s that I am reserving at $45 per week

Please select your lunch options

Camp Tuition and Fees Policy

Enrollment in the camp program constitutes a binding financial commitment for the full session or specific weeks selected at registration, whether for the eight (8) week program or individual weeks, and by enrolling, the parent(s)/guardian(s) agree to pay all tuition and associated fees as selected, regardless of withdrawal, absence, or non-attendance for any reason; a non-refundable $100 registration fee and $250 security fee are due upon registration, all remaining tuition must be paid as agreed, any returned payment will incur a $25 administrative fee, and attendance may be denied if the account is not current; participation in the lunch program is optional, but all lunch fees once assessed or paid are non-refundable and non-proratable; all tuition and fees are non-refundable, and no refunds, credits, or reductions will be granted for illness, holidays, vacations, or any other reason, and in the event of early withdrawal, the parent(s)/guardian(s) remain fully responsible for the full tuition amount without proration; if the camp is closed or operations are modified due to weather or other circumstances beyond the School’s control, there will be no refunds, credits, or make-up days; attendance is contingent upon compliance with all School requirements, including health and immunization documentation, and the School reserves the right to suspend or terminate participation for nonpayment or policy violations; by enrolling, the parent(s)/guardian(s) acknowledge and agree to be bound by this Tuition and Refund Policy, which is incorporated into the camp registration agreement.

Signature*

Print Name*

Please upload your documents: Photo of child, copy of child’s birth certificate, copy of parents’ Government Issued Photo ID, Current Medical Forms and Immunization Records for child. If you are a current DJP student please confirm with the office that all your paper work is up to date.

Drop files here or

Max. file size: 50 MB.

Registration

The DJC CAMP registration form

CHILD'S INFORMATION:

FAMILY INFORMATION:

Mother's Information

Father's Information

Camp Tuition and Fees Policy