MoEd Summer 2019 Sign-Up: June 17-Aug 2
Please fill in the required fields.
Sign in to Google to save your progress. Learn more
Registration Fee
$100 deposit per camper required for registration. Make check payable to “MoEd” and mail check to MoEd:
8300 Meadowbrook Lane, Chevy Chase, MD 20815, or drop it off at Ohr Kodesh in the MoEd mailbox or give it to one of our staff members.  

Questions? Call 240-450-0689 or email contact@moedcommunity.org.
Parent/Guardian #1 Name *
First and Last name
Parent/Guardian #1 Telephone No. *
Parent/Guardian #1 Email Address *
Parent/Guardian #2 Name
First and Last name
Parent/Guardian #2 Telephone No.
Parent/Guardian #2 Email
Other: Grandparent/Babysitter/Guardian Name
First and Last name
Grandparent/Babysitter/Guardian Telephone No.
Grandparent/Babysitter/Guardian Email
House No. *
Home Address
Street name *
Home Address
City *
Home Address
State *
Home Address
Zip *
Home Address
Child 1 Name *
First and Last name
Child 1 Nickname
Child 1 Grade *
Child 1 Age *
Age in June 2019
Child 1 Gender *
Child 1: Register for week
One week or up to all seven weeks.
Full Day (9 am - 6 pm)
9 am - 3 pm
Week 1: June 17-21
Week 2: June 24-28
Week 3: July 1-5 (Closed 7/4)
Week 4: July 8-12
Week 5 :July 15-19
Week 6: July 22-26
Week 7: July 29-Aug 2
Clear selection
Child 1 Hebrew Knowledge
Child 1 Food Restrictions/Allergies *
Child 2 Name
First and Last name
Child 2 Nickname
Child 2 Grade
Child 2 Age
Age in June 2019
Child 2 Gender
Child 2: Register for week
One week or up to all seven weeks.
Full Day (9 am - 6 pm)
9 am - 3 pm
Week 1: June 17-21
Week 2: June 24-28
Week 3: July 1-5 (Closed 7/4)
Week 4: July 8-12
Week 5 :July 15-19
Week 6: July 22-26
Week 7: July 29-Aug 2
Clear selection
Child 2 Hebrew Knowledge
Child 2 Food Restrictions/Allergies
Child 3 Name
First and Last name
Child 3 Nickname
Child 3 Grade
Child 3 Age
Age in June 2019
Child 3 Gender
Child 3: Register for week
One week or up to all seven weeks.
Full Day (9 am - 6 pm)
9 am - 3 pm
Week 1: June 17-21
Week 2: June 24-28
Week 3: July 1-5 (Closed 7/4)
Week 4: July 8-12
Week 5 :July 15-19
Week 6: July 22-26
Week 7: July 29-Aug 2
Clear selection
Child 3 Hebrew Knowledge
Child 3 Food Restrictions/Allergies
Will you need Early Drop Off? *
If so, please indicate what time you would like to drop off in the "Anything Else" box below. We are flexible and will do our best to accommodate your needs!
Are you interested in swimming lessons for your child(ren)? *
If yes/maybe, please give us more information in the "Anything Else" box.
Anything else we should know?
Anything you would like us to know about your children, etc. that wasn't already covered.
Registration Fee
$100 deposit per camper required for registration. Make check payable to “MoEd” and mail check to MoEd:
8300 Meadowbrook Lane, Chevy Chase, MD 20815, or drop it off at Ohr Kodesh in the MoEd mailbox or give it to one of our staff members.  

Questions? Call 240-450-0689 or email contact@moedcommunity.org.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of MoEd Community. Report Abuse
Google Forms