CSL Connections Host Registration Form
Full Name of Host
*
First Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
Please include names, phone numbers, and emails for each person in your home over the age of 18 (this information is for background check conducted by the JCC):
I would like to host the following dates (last remaining):
July 26- 29th
Do you have a preference to host male or female camper?
How many campers are you willing to host?
Please Select
2
3
4
5
Is there any additional information you would like us to know?
Submit
Should be Empty: