Camp Toras Chaim WAIT LIST Application Form

Camp Toras Chaim WAIT LIST Application Form

Summer 2026
All groups are currently FULL. You can join our waiting list by filling out this application form. Please DO NOT send a deposit.
Child Information
Last name*
Child's First name*
Child's Date of Birth*

MonthDayYear
Date
Child's Age*
please note we are currently only accepting 4 year old boys and 4 & 5 year old girls, all other age groups are full
Has this child or any siblings previously attend CTC?

YesNo
Gender

malefemale
Child's Current Grade*
School Attending*
Grade Entering in September 2026*
Teacher's Name
Parent Information
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Father's Title
Father's Name*
Father's Cell Phone Number*
Please enter a valid phone number.
Mom's title
Mother's Name*
Mother's Cell Phone Number*
Please enter a valid phone number.
Main Email Address*
camp emails will be sent to this email address
Preferred number to receive camp text messages*
updates and announcements will be sent via text msg
Father's Employer
Mother's Employer
secondary email address
example@example.com
Names and Ages of Siblings
Emergency Contact and Medical Information
Emergency Contact Name*
Relationship to Child*
Emergency Contact Phone Number*
Please enter a valid phone number.
Pediatrician's Name*
Pediatrician's Phone Number*
Please enter a valid phone number.
Dentist's Name*
Dentist's Phone Number*
Please enter a valid phone number.
Does your child recieve any services?
Check all that apply
Allergies:
Family Shul Affiliation*
Name of Rabbi*
Notes or any other important information:
Please place my child with:
or
or
we will try to accommodate at least one friend request
Registration Details

PLEASE DO NOT SEND A DEPOSIT FOR OUR WAITING LIST, WE WILL NOTIFY YOU IF A SLOT OPENS UP
I UNDERSTAND THAT IF A SLOT OPENS UP, I WILL BE NOTIFIED AND A $300 REGISTRATION FEE (DEPOSIT) MUST BE SENT IN ORDER FOR MY APPLICATION TO BE CONSIDERED AT THAT POINT.

I understand
How do you plan to send $300 Registration fee

Chase QuickPay/Zelle $300 camptoraschaim@gmail.commail check payable to CAMP TORAS CHAIM to 1052 Highland Place, Woodmere NY 11598
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Camp Toras Chaim WAIT LIST Application Form

All groups are currently FULL. You can join our waiting list by filling out this application form. Please DO NOT send a deposit.

Child Information

Parent Information

Emergency Contact and Medical Information

Registration Details