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Camp Application

Masmidim Application

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OORAH'S BOYZONE MASMIDIM APPLICATION - 2010 Season

Please fill out an application for each camper.
We will NOT process your application unless it is completed in full.
If it is not applicable to you, please write "None".

Camper's Information Camper's Last Name:
Camper's First Name:
Camper's Address:
Apt #:
City:
State:
Zip:
Country:
Camper's Home Phone:
Emergency Contact Name:
Emergency Contact Number:

Father's Information Father's Last Name:
Father's First Name:
Father's Occupation:
Father's Business Phone:
Father's Cell Phone:
Father's Email:

Mother's Information
Mother's Last Name:
Mother's First Name:
Mother's Occupation:
Mother's Business Phone:
Mother's Cell Phone:
Mother's Email:

Family Information Parents' Marital Status:

If separated, widowed or divorced, who does the child stay with?

If divorced, who has legal custody of the child?

How many siblings does Camper have?

Siblings' Ages:
Schools Siblings attend:

Schools Siblings attend:

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Additional Camper Information Camper's Preferred Name:
Camper's Date of Birth: (mm/dd/yyyy) Invalid format.A value is required.

Camper's Social Security #:
Camper's Ethnicity:
Campers' Email Address:
Camper's Cell Phone:
Camper's current Grade(as of 08-09):

Camper's Current School:
Attended Since(year):
Camper's Hebrew Teacher:

Camper's Previous Schools:

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Camper's Previous Camps:

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Camper's friends attending Masmidim:

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Camper'sSpecial skills or interests:

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Where did Camper go last summer?

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Why do you want to come to our camp?

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Are there any Special Instructions for this Camper?
(allergies, medications)

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How did you hear about Masmidim?

Other:

Camper References List two references, such as your school Principal, Rabbi, Teacher, Counselor or Community Rabbi.
Reference Name:
Daytime Phone
Evening Phone
Relationship to Camper:
Reference Name:
Daytime Phone
Evening Phone
Relationship to Camper

Camper's Family Affiliation Status of Applicant: Born Jewish Converted Not Jewish

Status of Applicant's Father: Born Jewish Converted Not Jewish

Status ofApplicant's Mother: Born Jewish Converted Not Jewish

If converted, year of conversion (xxxx year): Invalid format.Minimum number of characters not met.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.Exceeded maximum number of characters.

Officiating Rabbi:

Synagogue affiliated with:
Rabbi's Name:
Rabbi's Phone:

Summer Camp Fees

July 13th-August 9th

Masmidim:
(entering Grades 10, 11, and 12 )
$1499

A deposit of $200 is required at the time of registration, to be applied to total camp fees. The deposit will be refunded if the applicant is not accepted to Camp.

Applications received without a deposit, for each applicant, will not be processed.
No refund for cancellations after May 1st.
Payment in full must be received by May 15th.

Additional Camp Information

For scholarship information, fill out the online financial aid application or please call us at 1.877.447.5966 .

For additional assistance, contact your local federation or visit the Foundation for Jewish Camping at www.jewishcamp.org

For help filling out this form, please call us at 1-866-JEWISH-BOY. If your application does not go through after hitting the 'Continue' button, please scroll to the top of the application and make sure the fields were filled out correctly.

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