Jewish Federation of Northwest Indiana

JCY Camp 2023 Registration

Camper Name

*

First Name

Last Name

Date of Birth

*

(mm/dd/yyyy)

Camper age at start of camp

*

Shirt size for JCY Camp T-Shirt

*

Parent/Guardian Name

*

First Name

Last Name

Email

*

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone Number

*

Session Selected

*

NO CAMP ON JULY 4TH

Full 6 week session (June 19th-July 28th)

1st 3 week session (June 19th-July 7th)

2nd 3 week session (July 10th-July 28th)

Camp lunches:

Lunch cost is $7 per lunch, per week. If you purchase all 5 lunches, the cost is $32.

All lunches will include fruit, raw veggies, chips, and dessert.

Each lunch is served once per week ~ a lunch calender will be distributed.

Lunches are purchased for the weeks your child is enrolled in camp. Once camp begins, there are no changes made to lunch orders. There are no refunds or credits for lunches not eaten.

Lunch options:

Please check the lunches you would like to purchase for the weeks your child is registered for camp.

JCY Lunchable

Grilled Cheese

Pasta

Hot Dog

Cheese Pizza

Tuition options

*

Tuition will be invoiced on the 5th of June. Full tuition must be paid by July 20, 2022.

I will pay the full tuition by June 20th. (This option includes a 5% discount.)

I would like to split my tuition into two invoices, one billed 6/5/22 and the second billed 7/5/22.

Email(s) to which invoices should be sent (separate by comma if multiple):

*

How did you hear about JCY camp?

Referred by:

Parent/Guardian Signature

*

Date

*

(mm/dd/yyyy)