HAR ZION DAY CAMP REGISTRATION - SUMMER 2024
June 24, 2024 - August 16, 2024
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Email *
Deposits and Fees
Please submit form and pay the $175 NON-REFUNDABLE AND NON-TRANSFERABLE* deposit. When you receive your full bill, the amount due will have been reduced by your deposit amount.

FOR NON-MEMBERS:
A $250 security fee will be billed per family per year
This fee is one time per family per year

Members pay the security fee when membership fees are billed.
Please note: We are thrilled to announce that our age 2, 4 and 5 bunks are completely full! Click below if you would like to be placed on the waitlist.
Child's First Name *
Child's Last Name *
Gender *
Birthdate *
MM
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DD
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Age as of 9/15/2024 (must be 2) *
Mailing Address
Number and Street *
City *
State *
Zip code *
Home Phone *
Parent/Guardian/Camper Information
Parent/Guardian 1 - First Name *
Parent/Guardian 1 - Mobile number *
Parent/Guardian 1 - Email address *
Parent/Guardian 2 - First Name *
Parent/Guardian 2 - Mobile number
Parent/ Guardian 2- Email address *
For emergencies and camp closings, please list the best mobile phone for texting *
Current Synagogue affiliation
We offer either an 8-week program or a 4-week program. For Membership rate, you must be a member for the 2024-2025 fiscal year.  Please select:
8 Week Program
4 Week Program
I will also need extended day 1:00pm - 3:15pm (for half day campers only)  (There is a daily option of $42 per day but MUST know 24 hours in advance)
I will need Late Care 3:15pm - 5:00pm 4-days a week for the entire summer. One day per week is $242 for the summer. (There is a daily option for $33 per day but MUST know  the day before)
Is there any other special information of which we should be aware (i.e. Allergies, Diet)?
Any additional information you would like us to know about your child? (Parent requests for specific placements cannot be honored. We ask your cooperation in refraining from making such requests)
Har Zion Day Camp has our permission to use any photo, picture, or likeness of our child or any family member for promotional purposes, including the Har Zion website, camp website and Facebook page.
Application Requirements & Financial Arrangements:
HAR ZION MEMBERS: In order for us to process your child’s application for Day Camp 2024 at the member rate, your 2023-24 membership dues must be paid in full at the time this application is presented to the office. If you have not paid your 2024-25 membership in full by September 1, 2024, or you do not have a signed acceptable payment arrangement with Har Zion, your Day Camp fees will be converted to the Non-Member rate retroactively.
TO ALL FAMILIES:
ALL FAMILIES: All Noreen Cook Center, Jane Fishman Grinberg Religious School and all other 2023-24 synagogue obligations must be current. Payment in full must be received by May 17, 2024 or have a signed acceptable payment arrangement with Har Zion to guarantee your child’s ability to begin camp
This application is a legally binding contract. All financial obligations owed to Har Zion Temple for the above named child are the responsibility of both parents. This application will not be processed unless both parents acknowledge this financial obligation by signing below. Any exceptions or special circumstances require the prior written approval of the Executive Director. *
Required
Har Zion Temple’s Day Camp reserves the right to terminate enrollment due to failure to meet financial obligation.
Payment Options: It is mandatory that a Payment Plan be selected *
Required
If you select to use a credit card: All Credit Card payments will incur a 2.5% processing fee added to each transaction. I understand that I must notify Har Zion Temple when my credit card expires or is cancelled and supply them with an updated card number. If credit card is declined, a replacement must be given within 15 days or a fee of $25 will be assessed on my account. Our Accounting Department will be in touch with you to collect your account information.
If you select to use your bank account - ACH Checking Account:  Please contact Rhoda Eisman at reisman@harziontemple.org to discuss banking information.   I understand that I must notify Har Zion Temple four (4) days prior to the 1st of the month if my checking account number changes and provide new banking information.  If an ACH payment is declined for any reason a $25 fee will be assessed on my account. Our Accounting Department will be in touch with you to collect your account information.
* CANCELLATION & REFUND POLICY: No refunds will be issued and/or credit transferred to any other division of Har Zion Temple for any reason unless adjustments need to be made because of the pandemic. Exceptions to this policy can only be made with written approval by the Executive Director.  Please note that if there are any special circumstances or problems of which the camp should be aware, please contact our Executive Director before this application is filed. This application is a legally binding contract. If HZT determines, in its discretion based on circumstances, that camp cannot run during the summer of 2024, a full refund will be given.
We have read and agree to be legally bound by all of the terms and conditions set forth above. *
A copy of your responses will be emailed to the address you provided.
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