2019 JCC Summer Camp Guide

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315-445-2360 | www.jccsyr.org 5655 Thompson Rd., DeWitt, NY 13214 2019 School-Age and Teen Camp Registration • Carefully read the registration and general camp information. • Please print neatly. • Mailing and billing will be sent to the camper’s address. • No third-party billing. • Many camps have grade and equipment requirements. Please check program descriptions before completing registration. • There will be a $20 fee for any changes made after initial registration. Use one form per child. No refunds after May 24. CAMPER INFORMATION Last Name First Name Address Date of Birth City State Zip Age School Grade Entering (2019-20) T-Shirt Size (check one) Youth: q 6-8 q 10-12 q 14-16 Adult: q S q M q L Child lives with q Parent #1/Guardian q Parent #2/Guardian q Both PARENT #1/GUARDIAN INFORMATION Last Name First Name Email Date of Birth Home Phone Cell Phone Work Phone Occupation PARENT #2/GUARDIAN INFORMATION Last Name First Name Email Date of Birth Home Phone Cell Phone Work Phone Occupation EMERGENCY CONTACT INFORMATION (other than parents—must be local) #1 – Last Name First Name Phone Alt. Phone Relationship #2 – Last Name First Name Phone Alt. Phone Relationship BUS TRANSPORTATION If the JCC will be busing you child, please refer to the bus stops on page 5 and indicate the AM and PM stops most convenient for you. AM ________________ PM ________________ HOW DID YOU HEAR ABOUT US? Please check all that apply. q Friend, neighbor or JCC member q JCC mailings q Attended camp before q Facebook q Twitter q Instagram q Post-Standard q Family Times q Syracuse Parent q Jewish Observer q Other: ORDER EXTRA T-SHIRTS q Yes! Please order my son/daughter the following extra camp T-shirts at $8 each. Number of shirts ______ x $8 = $____________ Size (check one) Youth: q 6-8 q 10-12 q 14-16 Adult: q S q M q L Please transfer your total number of extra T-shirts and dollar amount above on to the other side of this form (page 9) as part of your total payment amount. Remember—every camper will receive a free T-shirt at the start of his/her first session. SIGNATURE My son/daughter has my permission to go on field trips during the time camp is in session. I understand that I will be informed of the exact date, time and destination of each trip in advance of departure. Field trips may be weather permitting. I give permission for my child to go on trips with persons designated by the JCC Camp Directors. I give permission for photographs of my son/daughter to be used in any camp publicity or promotion. ___________________________________________________ ____________________________________________________ ____________________ Camper’s Name Parent/Guardian Signature Date FOR OFFICE USE ONLY Payment Received _________________ Amount _______________ Date _____________ Initials ____________ Class List ________________________ Tracking _______________ Daxko ____________ 10 JCC of Syracuse | 2019 Summer Camp Guide
315-445-2360 | www.jccsyr.org JEWISH COMMUNITY CENTER - CAMP ROMANO 2019 Early Childhood Camps Registration Tenokia Early Childhood Camps 6 weeks - 18 month • One form per child • Please print neatly • All boxes must be completed • Please read general information before completing this form • Mailing and billing will be sent to the Camper’s address • Please indicate days and times for your child’s camp registration below. • There will be a $20 fee for any changes made after initial registration K’Ton Ton Chaverim Yeladim Gesher 18 month - 2 years old 3 year olds 4 year olds Entering Kindergarten No refunds after May 24. CAMPER Last Name First Name Age (yr. mo. ) Address Birthdate City State Zip Phone E-mail Physician PARENT #1 / GUARDIAN INFORMATION Last Name First Cell: Phone/Employer PARENT #2 / GUARDIAN INFORMATION Phone E-mail: Last Name First Cell: Phone /Employer E-Mail: EMERGENCY CONTACT INFORMATION (Other than parent) MUST BE LOCAL Name Day Phone Relationship Name Day Phone Relationship PAYMENT INFORMATION Are you a JCC member? Yes No JCC Member # Payment Method Account Number Cardholder Name Cash Check Credit Card BILLING SUMMARY Total Camp Fees Total Weeks 1–4 Total Weeks 5–8 Registration Fee $25 Deposit $50/week Total Amount Due Now Week 1 July 1 - 5 (not 7/4) M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Week 2 July 8 - July 12 M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Week 3 July 15 - July 19 M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Week 4 July 22 - July 26 M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Week 5 July 29 - August 2 M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Week 6 August 5 - August 9 M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Week 7 August 12 - August 16 M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Week 8 August 19 - August 23 M-F M/W/F T/TH 9-1 7:00-1 9-3:45 7:00-6 Expiration Date Signature V-Code: Total Amount Enclosed Balance due on 6/14/19 Balance due on 7/15/19 T-Shirt Size (Circle) 6m 12m 18m 2T 3T 4T Youth Small Youth Medium FOR OFFICE USE ONLY Payment Received ____________ Amount ____________ Date ____________ Initials ____________ Class List _________________ Tracking _________________ Daxko __________________________ JCC of Syracuse | 2019 Summer Camp Guide 11
Page 1 and 2: JCC CAMP JCC CAMP RISHON Joe & Lynn
Page 3 and 4: Welcome to JCC camp Joe & Lynne Rom
Page 5 and 6: 315-445-2360 | www.jccsyr.org JCC C
Page 9: 5655 Thompson Rd., DeWitt, NY 13214
Page 13 and 14: 5655 Thompson Rd., DeWitt, NY 13214
Page 15 and 16: 315-445-2360 | www.jccsyr.org Pleas
Page 17 and 18: Dance • Week 1: July 1-5 (not 7/4
Page 21 and 22: JCC Camp Romano 315-445-2360 | www.
Page 23 and 24: 315-445-2360 | www.jccsyr.org SyraC

2019 JCC Summer Camp Guide

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