Winter Break with Ramah

Please enter the names of anyone who might participate in virtual camp here:*
Parent Name*

First NameLast Name
Parent Email*
example@example.com
(Optional) Second Parent Name

First NameLast Name
(Optional) Second Parent Email
example@example.com
Which programs are you interested in participating in? (This is only to approximate attendance and not a firm commitment.)*

Mad Science (December 23rd)Shishi Al HaMigrash (December 25th)Joke-Telling (December 28th)Drumming (December 30th)

Please enter the names of anyone who might participate in virtual camp here:*
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Optional Second Parent Name

First NameLast Name
(Optional) Second Parent Email
example@example.com
Phone Number*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you planning to enroll any of your children for summer 2021?*

Planning to enrollNot planning to enrollUnsureOther
Which programs are you interested in participating in? (This is only to approximate attendance and not a firm commitment.)*

Mad Science (December 23rd)Shishi Al HaMigrash (December 25th)Joke-Telling (December 28th)Drumming (December 30th)

Signing below confirms that you have read the Ramah Nyack virtual programming information and above permission statements, that you understand it, and that you agree to be bound by it.*

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