2017 JCC Summer Camp Guide
The JCC of Syracuse's Summer Camp offers programs for infants, preschoolers, school-age children and teens. Camp runs June 26 - August 18, 2017.
The JCC of Syracuse's Summer Camp offers programs for infants, preschoolers, school-age children and teens. Camp runs June 26 - August 18, 2017.
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315-445-2360 | www.jccsyr.org<br />
JEWISH COMMUNITY CENTER - CAMP RISHON<br />
<strong>2017</strong> Early Childhood <strong>Camp</strong>s Registration<br />
Tenokia<br />
Early Childhood <strong>Camp</strong>s<br />
6 weeks - 18 month<br />
• One form per child<br />
• Please print neatly<br />
• All boxes must be completed<br />
• Please read general information<br />
before completing this form<br />
• Mailing and billing will be sent<br />
to the <strong>Camp</strong>er’s address<br />
• Please indicate days and times for<br />
your child’s camp registration below.<br />
• There will be a $20 fee for any changes<br />
made after initial registration<br />
K’Ton Ton<br />
Chaverim<br />
Yeladim<br />
Gesher<br />
18 month - 2 years old<br />
3 year olds<br />
4 year olds<br />
Entering Kindergarten<br />
No refunds after May 19.<br />
CAMPER<br />
Last Name First Name Age (yr. mo. )<br />
Address<br />
Birthdate<br />
City State Zip<br />
Phone<br />
E-mail<br />
Physician<br />
PARENT #1 / GUARDIAN INFORMATION<br />
Last Name First Cell:<br />
Phone/Employer<br />
PARENT #2 / GUARDIAN INFORMATION<br />
Phone<br />
E-mail:<br />
Last Name First Cell:<br />
Phone /Employer<br />
E-Mail:<br />
EMERGENCY CONTACT INFORMATION (Other than parent) MUST BE LOCAL<br />
Name Day Phone Relationship<br />
Name Day Phone Relationship<br />
PAYMENT INFORMATION<br />
Are you a <strong>JCC</strong> member? Yes No<br />
<strong>JCC</strong> Membership #<br />
Payment<br />
Method<br />
Account<br />
Number<br />
Cardholder<br />
Name<br />
Cash<br />
Check<br />
Credit Card<br />
BILLING SUMMARY<br />
Total <strong>Camp</strong> Fees<br />
Total Weeks 1–4<br />
Total Weeks 5–8<br />
Registration Fee $20<br />
Deposit $35/week<br />
Total Amount Due Now<br />
Week 1 June 26 - June 30<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Week 2 July 3 - July 7 (not 7/4)<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Week 3 July 10 - July 14<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Week 4 July 17 - July 21<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Week 5 July 24 - July 28<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Week 6 July 31 - August 4<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Week 7 August 7 - August 11<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Week 8 August 14 - August 18<br />
M-F M/W/F T/TH<br />
9-1 7:00-1 9-3:45 7:00-6<br />
Expiration<br />
Date<br />
Signature<br />
V-Code:<br />
Total Amount Enclosed<br />
Balance due on 6/15/17<br />
Balance due on 7/15/17<br />
T-Shirt Size (Circle)<br />
6m 12m 18m 2T 3T 4T<br />
Youth Small Youth Medium<br />
FOR OFFICE<br />
USE ONLY<br />
Payment Received ____________ Amount ____________ Date ____________ Initials ____________<br />
Class List _________________ Tracking _________________ Trinexum __________________________<br />
<strong>JCC</strong> of Syracuse | <strong>2017</strong> <strong>Summer</strong> <strong>Camp</strong> <strong>Guide</strong> 13
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