• ECLC Summer Camp Enrollment Form

    Summer 2021
  • Welcome to the Rosen JCC's Early Childhood Learning Center 2021 Camp Enrollment Form.

    Our 2021 Summer Camp Programs are currently at capacity!

    If you have any questions, please contact Dr. Phyllis Bochman at Phyllisb@rosenjcc.org or 321-319-4702.

  • Section 1 - Rosen JCC Membership

  • Section 2 - Camper Information

    Next, help us learn a little more about your camper. This information will help us provide the best possible care for your child.
  •  -  - Pick a Date
  •  -  - Pick a Date
  • Section 3 - Household Information

    Now we need to collect some information about you, the parents/guardians! This information will help us contact you, if needed. Please enter the most up-to-date information.

    • Parent/Guardian 1  
    •  -
    • Parent/Guardian 2  
    •  -
  • Section 4 - Camp Registration/Sessions

  • Section 5 - Terms and Conditions

  •  -  - Pick a Date
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  • Should be Empty: