I am registering for:
Camp Oraysa Boys
Camp Oraysa Girls
Camp Oraysa Junior
Have you registered a child before at Camp Oraysa?
No
Yes, I already registered a child, and now I'm registering another one.
Camper Name
First Name
Last Name
Grade completing
1
2
3
4
5
We are currently accepting applications for grades 1-5. For older campers, please contact Rabbi Eli NIssel directly at 970-402-2281 or enissel@dataofplano.org.
Camper Age (as of June 21, 2021)
Parent Email
example@example.com
Parent Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registering for:
Week 1: June 27 - June 31
Week 2: July 4 - 8
Week 3: July 11 - 15
Week 4: July 18- 22
Week 5: July 25 - 29
Week 6: August 1 - 5
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Medical Information
Does the camper have allergies or medical conditions that are important for the camp to know about?
Please explain on the field provided
Is the camper currently under medication?
Please provide the details, the name of the medication and period of intake
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Contact Information in Case of Emergency
Name
First Name
Last Name
Contact Number
-
Area Code
Phone Number
Relation to camper
Name
First Name
Last Name
Contact Number
-
Area Code
Phone Number
Relation to camper
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Would you be interested in transportation from the south eruv, for an additional fee (Based on demand)?
Yes
No
Maybe
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Payment
Signature of parent or guardian representative
My Products
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( X )
Deposit
$
200.00
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: