Aish Camp 2020

February break camp is SOLD OUT. If you would like to be added to our waiting list please email our camp director Malkie Friedman at malkiefriedman@aish.edu

Is this your family's first experience with Aish Camp?

YesNo
Parents Information
Moms Info*

Mom's First NameMom's Last Name
Mother's Email*
We like to tag parents in pictures on our social media! What is your Instagram handle(s)? (optional)
Mother's Cell*
Dad's info

Dad's First NameDad's Last Name
Father's Email
Father's Cell
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary email for us to contact
example@example.com

Campers Name*

First NameLast Name
Birthday*

MonthDayYear
Date
Age*
Please note that all campers must be potty trained
Current Grade*
School attending*
T-shirt Size*

Extra SmallSmallMediumLarge
Select the Day(s) your child will be attending
February Break Camp ($60/day)

Monday, February 21Tuesday, February 22Wednesday, February 23Thursday, February 24Friday, February 25

Emergency Contact

Emergency contact must be someone other than the parents
*
Please list any additional people that may pick up or drop off your kids (someone other than Mom or Dad who may drop off or pick up your child)

Parental Consent for Emergency Treatment

I hereby consent to allow the administrators of the Camp Aish to take whatever medical measures necessary at my expense, for my child, in the event of a medical emergency.
Signature*

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Date:*

MonthDayYear
Date
Liability WaiverRelease and Indemnification
I, the undersigned parent of*
hereby consent to my child's participation in Camp Aish activities. I hereby release, waive, discharge and indemnify Camp Aish, their affiliates, agents, officers, directors, supervisors, and employees (herein referred to collectively as "Camp Aish") from and against any and all claims for property damages, liability or personal injuries which my child may sustain. I further agree to indemnify and defend against any and all claims for property damages, liabilities, or personal injuries which a third party may sustain by reason of any act or omission of my child.

Additionally, I understand that my child or children's pictures taken while participating in any camp activities may be used by Aish for their marketing purposes.
Signature*

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Date:*

MonthDayYear
Date

Camp Tuition

Registration Fee$35.00

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Total $0.00

Parents Information