Chabad Five Towns Winter Camp 2024

Winter Camp 2024 Information:

December 31 - January 2

Lunch & Snacks included

Open to children in grades 1-7

Please note: winter camp is for district public school children!
Chabad Five Towns Winter Camp Application
Number Of Children Registering*

Parent Information
Mother Name *

First NameLast Name
Email*
example@example.com
Cell Phone Number *
Please enter a valid phone number.Format: (000) 000-0000.
Father Name

First NameLast Name
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com

Emergency Contact
Name*

First NameLast Name
Email
example@example.com
Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to camper *

Payment

Tuesday - Urban Air

$65 Number of Children Attending

Wednesday - Ferox

$65 Number of Children Attending

Thursday - Bounce

$65 Quantity

Enter coupon

Total

$0.00

Payment

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Questions: Comments: Concerns:
We are looking forward to having your child join winter camp!

Hadassah Geisinsky will be in touch with you with all camp updates - If you have any questions feel free to reach out to Hadassah - 516-458-3694
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