SSC  Jewish Adventure Camp
Summer 2024 • Jewish Adventure Camp Registration
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Email *
Select 3-Week Session Start Date(s) *
Required
First Name (as appears on passport or US driver's license) *
Last Name (as appears on passport or US driver's license) *
Name used in public.  (e.g. Shimmy) *
Hebrew name (e.g. Reuven ben Shimon) *
Hebrew name suffix *
Camper Email *
Street Address *
City *
State *
Zip Code *
Country of Citizenship *
Birthday *
MM
/
DD
/
YYYY
Passport # (if foreign student)
Camper Mobile Phone number *
Father's Name *
Father's Mobile Phone Number *
Father's address (if different).  Write SAME if the same as the student. *
Father's Email *
Mother's Name *
Mother's Mobile Phone Number *
Mother's address (if different).  Write SAME if the same as the student. *
Mother's Email *
US Emergency Contact (if foreign student)
US Emergency Contact Phone (if foreign student)
US Emergency Contact Email (if foreign student)
Name of School/Yeshiva (and city) *
Name of Rabbi/Rav *
Name of Shul/Synagogue *
How Did You Learn About Us (briefly tell us how you found out about our program) *
HEALTH: Have you or any members of your immediate family ever suffered from: asthma, allergies, digestive tract disorders, blood disorders, cancer, heart condition, epilepsy, or other notable illness? *
HEALTH: If Yes, Please Describe Health Issues
                 If No, write N/A
*
HEALTH: Have you ever undergone surgery or had a prolonged illness? *
HEALTH: If Yes, Please Describe Surgery or Illness 
                 If No, write N/A
*
HEALTH: Have you or any members of your immediate family ever suffered from a mental illness, emotional disturbance, depression, autism spectrum disorders, anxiety, learning disabilities or eating disorders? *
HEALTH: If Yes, Please Describe Psychological Concerns
                 If No, write N/A
*
HEALTH: Please List Prescribed Medications, if Any  (Bring photocopies of your current prescriptions with you.)
If None, write N/A
*
VIOLATION OF ALCOHOL AND DRUG POLICY: USE OR POSSESSION or MISCONDUCT EXAMPLES THAT COULD RESULT IN DISCIPLINARY ACTION OR EXPULSION WITHOUT REFUND
Examples of misconduct that that can get you expelled:
a. possessing or giving someone else any kind of weapon (including a toy gun) or dangerous object
b. giving other students over-the-counter medications like caffeine pills, pain killers, cough suppressant, etc.
c. hurting or threatening to hurt another student or a teacher
d. making violent threats, like writing a note that says there’s a bomb in the school
e. harassment of bullying (cyber or actual) of a fellow student or staff member
f. hacking facility or fellow student's computer system, wifi, telecommunications, mobile phone, etc.
g. defying teachers or other school officials or staff of places the students visit
h. any unauthorized student use, possession, sale or distribution of alcohol, controlled substances, imitation controlled substances, and/or similarly harmful substances, or drug paraphernalia -- either on campus or off campus

The staff member shall:
a. notify the parents, and also previous and upcoming rebbes;
b. notify the appropriate law enforcement agency and provide the agency with all confiscated evidence and information;
c. schedule a parent teleconference (Zoom, Facetime, etc.); and        

The student shall, in the case of substance policy:
a. sign a non­use contract with the parent and staff designee;
b. reveal source of material associated with this violation;
c. not participate in activities until consensus with parents and staff has been achieved.    

The student shall, in the case of disciplinary concern:
a. sign a non­-repeat contract with the parent and staff designee;
b. not participate in activities until consensus with parents and staff has been achieved.    

NOTE:  The choice to allow the student to remain is at the discretion of the Spokane Sephardic Center with the guidance of Rabbi Sam Kassin.  Student and parent accept that violation of misconduct and substance policies shall result in both forfeit of refund of fees and result in transportation to the Spokane Airport for return home at the parent's expense.  

After your registration is complete, a copy of this disciplinary policy will be emailed to parents for their signature to be returned to office@jewishadventurecamp.com
READ CAREFULLY
SIGNATURES:  After your registration is complete, a copy of the disciplinary policy will be emailed to parents for their signature(s) to be returned to office@jewishadventurecamp.com.  All of this information is necessary -- in advance -- in case of emergency or need for medical attention.

GUARANTEEING YOUR SPOT:  Registration is not confirmed until non-refundable registration payment of $1000 is received.  We will send you an invoice which must be paid in full 2 weeks before arrival.  Your deposit will be applied against the balance due.

VISITING:  Like other summer camps, we are not staffed to provide more than a single visiting day per session.  Overnight accommodations are based on availability of hostel-style bunk-bed sleeping quarters and may be additionally restricted by COVID or other local quarantining laws to ensure the safety of campers and staff.  On-site accommodations for visitors will have separate per-diem fee for room & kosher meals and must be paid in full 2 weeks prior to arrival.  We will try to provide a list of nearby AirBNB and hotels on our website and we will work with you to make arrangements for kosher meals.
REQUIRED -- EMAIL IMAGES OF THE FOLLOWING to:
      eligross144@gmail.com
Cc: eitanyosher@gmail.com

For FOREIGN CITIZEN:  A copy of your passport page showing your photo, name & passport #

For ALL CAMPERS:  A recent photograph of the camper.  
                             Both sides of the camper's health insurance card.
Add Your Own Comments and/or Questions
A copy of your responses will be emailed to the address you provided.
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