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CAMP YTT REGISTRATION FORM 2022-5782
Camp Fees: $4950 (does not include Airfare and $200 Registration fees)
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* Indicates required question
Email
*
Your email
First Name(s)
*
As it appears in your passport
Your answer
Middle Name
Your answer
Last Name
*
As it appears in your passport
Your answer
Preferred Name
*
Your answer
Hebrew Name
*
Your answer
Mothers Hebrew Name
*
Your answer
Date of Birth
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MM
/
DD
/
YYYY
Hebrew Birthday
*
Your answer
Home Address
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Your answer
City, State
*
Your answer
Country
*
Your answer
Grade
*
Choose
10th Grade
11th Grade
Name of School
*
Your answer
Principal's Name
*
Your answer
Principal's phone number
*
Your answer
Principal's email address
*
Your answer
Campers Email Address
*
Your answer
Primary email for communication with parents
*
Your answer
Home Phone Number
*
Your answer
Campers Cell Phone Number
*
Your answer
Anything we should know about your daughter?
*
Your answer
Where did you daughter spend last summer?
*
Your answer
Fathers Name
*
Your answer
Father's Cell Phone Number
*
Your answer
Father's Email Address
*
Your answer
Father's Marital Status
*
Choose
Married
Divorced
Seperated
Widowed
Mothers Name
*
Your answer
Mothers Maiden name
*
Your answer
Mother's Cell Phone Number
*
Your answer
Mother's Email Address
*
Your answer
Mother's Marital Status
*
Choose
Married
Divorced
Seperated
Widowed
Emergency Contact Name
*
Your answer
Emergency Contact Number
*
Your answer
Relationship to camper
*
Your answer
How important is Tznius to you?
*
Your answer
How do you define Chassidishkeit?
*
Your answer
What are your special strengths or talents?
*
Your answer
Tee shirt size, to fit loosely
*
Choose from drop-down list below
Choose
12 - Youth Large
14 - Youth Extra Large
16 - Adult Small
18 - Adult Medium
20 - Adult Large
22 - Adult Extra Large
24 - Adult XX Large
10 - Youth Medium
Write a paragraph describing why you want to go to Camp YTT
*
Your answer
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