School Age Summer Camp Registration 2023
It's time to register for School Age Summer Camp 2023!

This form is for children who have completed Kindergarten up through those that will turn 13 years old before September 1st.

The Summer 2023 will run from Monday, June 26th through Friday, August 25th, however we cannot accept any children for the last week of camp who have not been registered for at least two additional weeks during the summer. RECC will be closed on Tuesday, July 4 in observance of Independence Day.

Our summer hours will be 6:30am to 5:30pm. This is a 5 day program.
Your may choose:
Regular Day (8:30 to 3:30) $317.00
Extended Day (6:30 - 5:30) $339.00

Tuition payments are due by the Monday of each week or the first of the month. Payments may be made by check, credit, or debit card via Procare. No refunds will be given. Any changes or cancellations must be made in writing (email) to the RECC Office at enrollment@adath.org BY JUNE 1, 2023 so as not to incur charges.

We will be providing a morning and an afternoon snack. Each child must bring a non-meat lunch everyday.

                                       *Please complete a separate form for each child*


Sign in to Google to save your progress. Learn more
Email *
Child's Last Name *
Child's First Name *
Available Weeks
Please choose which weeks you would like your child to attend
Week 1:  June 26 - June 30   Celebrating you
Week 2:  July 3 - 7                   Game Show Mania (closed Tuesday, July 4th)
Week 3:  July 10 - 14              Junior Engineer
Week 4   July 17 - 21              Adventure Week
Week 5:  July 24 - 28              Superheroes Among Us
Week 6: July 31 -August 4    Musicales
Week 7:  August 7 - 11           Back in Time
Week 8:  August 14 - 18         Artful Antics
Week 9:  August 21 - 25         Around the World in 5 Days
Week 1
Clear selection
Week 2
Clear selection
Week 3
Clear selection
Week 4
Clear selection
Week 5
Clear selection
Week 6
Clear selection
Week 7
Clear selection
Week 8
Clear selection
Week 9
Clear selection
Child's Birthdate *
MM
/
DD
/
YYYY
Grade entering in September *
Allergies/Dietary Restrictions or Special Needs
 *
Youth Tee Shirt Size *
Pool Permission *
I give my child permission to participate in the pool. The pool is 2 ft deep to 5 ft deep and children must pass a swimming test to use the deep end (over 2 ft). A certified Lifeguard will always be supervising when the pool is in use in addition to the required ratio of staff.
Required
Media Consent
The following form will grant Rothschild Early Childhood Center and Temple Adath Yeshurun permission to use your child's image and name as specified below:
Newspapers/Online News Outlet *
First & Last Name, as well as photo to appear.
Required
Photograph in Online Media *
Name will NOT be included
Required
Photograph in Print Media *
Name will NOT be included
Required
Appearance in Video Media *
Name will NOT be included
Required
Mailing Address (Street, City, State, Zip *
Parent/Guardian 1 Last Name *
Parent/Guardian 1 First Name *
Parent/Guardian 1 Email Address *
Parent/Guardian 1 Phone Number *
Please give the phone number where you can be reached while your child is at camp
Parent/Guardian 2 Last Name
Parent/Guardian 2 First Name
Parent/Guardian 2 Email Address
Parent/Guardian 2 Phone Number
Please give the phone number where you can be reached while your child is at camp
I understand that School Age Summer Camp is a 5 day program and a part time option is not available *
Required
Application Fee *
Non-Refundable. $15 per child for Summer Camp. Applications will not be processed until the application fee has been received. The fee may be paid via check, credit, or debit through Procare or a check in the mail.
Name of person who completed this form *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Adath.org. Report Abuse
Google Forms