Camp Application

Jewish Community Center of Jersey Shore 100 Grant Avenue, Deal, NJ 07723 Phone: (732)531-9101
Parent #1 Name
Parent #1 Phone
Parent #2 Name
Parent #2 Phone
Parent Email
Summer Address Info
Street Address
City
State
Zip
Winter Address Info
Winter Address Street
Winter City
Winter State
Winter Zip
Emergency Contact Info
Emergency Contact #1 Name
Emergency Contact #1 Phone
Emergency Contact #2 Name
Emergency Contact #2 Phone
$500 Deposit Per Child Pricing is in USD
Payment Information Please Note: Refund Policy
First Name
Last Name
Address
City
State
Zip
Payment Method
Card Type
Card Owners Name
Card Number
CVV
Expiration Date
Transportation is provided as a Courtesy for children 3 yrs old – 10. Children under the age of 3 must be transported by the parent. Order of pick up and take home is at the discretion of the transportation director. Summer address must be given to the camp by no later than June 1, 2020 to ensure a spot on the bus. There are no credits or discounts given for late enrollment or early dismissal from camp. Balance of camp must be paid in full by June 1, 2020 . Checks can be made payable to the JCC and all credit cards will have a 2.5% surcharge.
Signature Clear

Child
Child's Name
School Attending
Birthdate
Please list any allergies
Friend Request #1
Friend Request #2
Please Select your Preferred Division 18 months - 2 years \| 9:15am-12:30pm- $2545 2 year olds \| 9:15am-2:45pm- $2795 3-5 years \| 9:15am – 3:45pm- $3250 6-10 year olds \| 9:15am-3:45pm- $3400