Pirchei Day Camp 2024
Early Bird - Ends June 14th
Pirchei Day Camp 2024
Admin Mode
If you are registering more than one camper, please fill out a separate form for each child!
Are you eligible for the Sibling Discount (2.5% off)?
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Yes. I am registering more than one child, please apply the Sibling Discount.
No. I am only registering one child, I do not qualify for the Sibling Discount.
Are you eligible for the New Family Discount (10% off)?
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Yes. Please apply the New Family Discount.
No. I have been to Pirchei before and I am looking forward to another fantastic summer!
Primary Email to be used for all Pirchei Communication
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Camper's Information
Camper First Name
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Camper Last Name
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Date of Birth
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Month
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Day
Year
T-Shirt Size
Please Select
YS
YM
YL
AS
AM
AL
AXL
Entering Grade in 2024/25
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Please Select
K
1
2
3
4
5
6
7
8
9
Please Select Which Weeks (Kindergarten - 5th Grade) - $220/wk (Early Bird)
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Week 1: June 24th - June 28th
Week 2: July 1st - July 5th (July 4th: 1/2 Day)
Week 3: July 8th - July 12th
Week 4: July 15th - July 19th
Please Select Which Weeks (Kindergarten - 5th Grade) - $230/wk
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Week 1: June 24th - June 28th
Week 2: July 1st - July 5th (July 4th: 1/2 Day)
Week 3: July 8th - July 12th
Week 4: July 15th - July 19th
Please Select Which Weeks (6th - 9th Grade) - $245/wk (Early Bird)
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Week 1: June 24th - June 28th
Week 2: July 1st - July 5th (July 4th: 1/2 Day)
Week 3: July 8th - July 12th
Week 4: July 15th - July 19th
Please Select Which Weeks (6th - 9th Grade) - $255/wk
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Week 1: June 24th - June 28th
Week 2: July 1st - July 5th (July 4th: 1/2 Day)
Week 3: July 8th - July 12th
Week 4: July 15th - July 19th
EarlyBirdCalc
Grade and Early Calc
Current URL
Today's Date
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Month
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Day
Year
Date
Early Bird Cutoff
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Month
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Day
Year
Date
Does your child have an allergies/medical conditions that we should know about?
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Primary Care Physician Name
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First Name
Last Name
Primary Care Physician Number
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At PDC we aim to help our campers grow in all areas. If there is anything you would like to share with us about your son that will help us give him the best summer possible (social issues, etc.), please fill in below
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Parents' Information - MOM
Mom
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First Name
Last Name
E-mail
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Cell Phone
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Home Phone
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Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parents' Information - DAD
Dad
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First Name
Last Name
E-mail
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Cell Phone
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Home Information
Please Select
Same as Mom
Different
Home Phone
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Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Statement of Understanding
I grant my child permission to go on all field trips with Pirchei Day Camp
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Type first and last name above to consent
I hereby release Pirchei of Atlanta and all of its employees of any liability arising during camp 2024
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Type first and last name above to consent
My child has permission to go home: (select all that apply)
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By Bike
Walk
I/Carpool will be taking him home
I have read the entire parent handbook and I agree to and accept all its' conditions including the refund and phone/electronic device policy.
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Yes
No
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Payment Details
Please choose your Method of Payment (For any questions about payment please call Rabbi Hiller 404.271.0820)
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Zelle: Please zelle money to info@pircheidaycamp.org
Paypal: A 2.5% fee will be added to cover service charge
Total Cost ( Prior to Discounts )
Session Discount
$10/wk if attending more than 3 weeks
Total Cost ( After Session Discount )
New Family Discount
10% off total for new families
Total Cost ( After New Family Discount )
Sibling Discount
2.5% off total for 2 or more campers
Registration Fee
Total Cost ( Before PayPal Fee )
PayPal Fee
2.5% added to total for covering PayPal fees
Total Payment Due
PLEASE NOTE: Registration isn't final until you have sent in payment!
Total Paypal Amount
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Debit or Credit Card
First Name
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Credit Card Number
Security Code
Card Expiration
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