Home Page | Jewish Federation of Greater El Paso | El Paso

Camp Shamayim Registration

 

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WELCOME TO CAMP SHAMAYIM, THE NON DENOMINATIONAL JEWISH DAY CAMP IN OUR REGION. We're excited to bring back this great program after many years of absence. 

JUNE 12-23, 2017

  SECTION 1: CONTACT INFORMATION Child 1

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Name:

 

 

 

     

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City/State/ZIP:

 

    

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Date of Birth:

 

 

What's this?

  Contact Information - Child 2

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Name:

 

 

 

     

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City/State/ZIP:

 

    

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Date of Birth:

 

 

What's this?

  Contact Information - Child 3

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Name:

 

 

 

     

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City/State/ZIP:

 

    

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Date of Birth:

 

 

What's this?

  Parent/Guardian Contact Information Parent/Guardian # 1

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Name:

 

 

 

 

     

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City/State/ZIP:

 

    

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What's this?

  Parent/Guardian # 2

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Name:

 

 

 

 

     

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City/State/ZIP:

 

    

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Date of Birth:

 

 

What's this?

  Alternate Pickup Release (Other than Parent/Guardian) Children will NOT be released to adults whose name is not on this form Alternate Pickup # 1

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  Alternate Pickup # 2

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Name:

 

 

   

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What's this?

   


  Alternate pickup # 3

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Name:

 

 

   

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REGULAR SCHEDULE FOR CAMP IS:

9 am to 3 pm for campers Kindergarten to 4th grade

9 am to noon for campers ages 2 to pre-K

AFTERCARE AVAILABLE FOR CAMPERS  2 to pre-K  for noon - 3 pm ($ 50/week)

ADDITIONAL CARE AVAILABLE FOR CAMPERS KINDERGARTEN TO 4TH GRADE - Early drop off (7:30 am) and/or Late pickup (5:00 pm) ($10/hour)

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Question - Required - CAMPER 1 SCHEDULE



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Question - Required - CAMPER 2 SCHEDULE



 
Question - Not Required - CAMPER 3 SCHEDULE



 

MEDICAL RELEASE INFORMATION

CAMPER 1

   


   


   


   


  PRIMARY PHYSICIAN

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Please list any Medical problem requiring special medication, including required treatment

 

 

 

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Question - Required - In case of emergency, should a paramedic be called?


 
Question - Not Required - Is your child being treated for an injury or sickness or taking any form of medication for any reason?


 

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Question - Required - IS YOUR CHILD ALLERGIC TO ANY TYPE OF FOOD OR MEDICATION?


 

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Question - Required - DOES YOUR CHILD REQUIRE A SPECIAL DIET?


 

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