Jewish Education Center of Cleveland



Camper Registration

First Name *

Last Name *

Childs Date of Birth

Current Grade *

Today's Date *

Phone *

Address *

City *

State *

Zip

Parent/Guardian 1 First Name *

Parent/Guardian 1 Last Name *

Parent/Guardian 1 Email *

Parent/Guardian 1 Phone *

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Email

Parent/Guardian 2 Phone

Select School Type *

Public

Private/Homeschooled

Jewish Day School

School *

Synagogue *

How would you describe yourself? *

Camp *

Your Camp Cost *
$

Camp Session *
First Time Camper Attending a Full Session (19+ days) First Time Camper Attending a Mini-Session (12-18 days) Second Time Camper Attending a Full Session Denominational Camp (19+days)

THANK YOU FOR REGISTERING FOR THE CAMP INCENTATIVE GRANT. YOU WILL BE RECEIVING AN EMAIL FROM THE JEC SOON WITH MORE DETAILS.

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