Camp Keshet 2023 Registration - Form

Weekly sessions available June 26–August 11 (No camp July 3–7)
Camp goes from 9-1 daily. Please pack a dairy, nut-free lunch

Primary Parent/Guardian Information

* First Name

* Last Name

* Email

* Cell Phone

Address

City

State

Zip

* Emergency Contact Name

First & Last

* Emergency Contact Phone

* Emergency Contact Relation to Child

Child's Information

* Child's First Name

* Child's Last Name

* Date of Birth

* Child's age group

* Is your child currently enrolled in Keshet preschool?

Please Select OneYesNo

Food Restrictions/Allergies

Medications

My child will attend:
Please select EITHER the entire summer OR individual week(s). To avoid overpayment, please do not make selections that overlap.

Entire Summer (6/26-8/11) (3-5 Year Olds)

Individual Week(s) (3-5 Year Olds)

Entire Summer (6/26-8/11) (Children who have just turned 2: 3 days a week-Tuesday, Wednesday, Thursday)

Individual Week(s) (Children who have just turned 2: 3 days a week-Tuesday, Wednesday, Thursday)

Additional Information About My Child

I understand that sunscreen must be applied before school. Would you like sunscreen reapplied to your child? If so, please explain frequency and location. Please provide a bottle of non-aerosol labeled sunscreen.

Please describe any challenges and or needs for your child, and how they are addressed:

Provide us any additional information that will help us best meet your child's needs at camp.

My child can be photographed

YesNo

I understand that there can be no outstanding balance from this year or last year to qualify for early registration.

I understand that all cancellations must be submitted in writing at least three weeks before your child is scheduled to attend otherwise I am required to pay in full. Absesnces due to illness or vacations will not be refunded.

I understand that payment must be paid in full prior to the week/s attending.

It is understood that this is a binding agreement. By typing your name below you allow it to act as your legal signature. It is understood that Keshet Preschool has many expenses of a continuing nature and thus it is essential that income from tuition be assured. We have read and understand this enrollment contract and agree that by signing it we accept responsibility for all financial obligations contained herein. (Please type parents names below.)

* Electronic Signature:

Enter first & last name

* Date of Signature: