CAMP APPLICATION

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CAMP ADMISSIONS FORM

31621The dates for Camp Chabad Summer 2026 are June 19 – August 15 ( We will be closed for July 4th on the 3rd)

There is a childcare option for the week in between school and camp, June 22 – June 20

The childcare week after camp, will be dependant on interest and availability.

CELC will be closed from August 25 – September 4 for Teachers In Service Week

Please fill out the form below to begin the camp application process.

Child Name*
First Last
Hebrew Name (If Known)
How Should Your Child Be Called?
Gender*
- Boy
- Girl
DOB*
MM slash DD slash YYYY
Time Of Birth
Age*
Home Phone*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Parent Information
Father's Name*
First Last
Father's Hebrew Name ( if known)*
First
Father's Cell*
Father's Email*

Please note that Camp Chabad uses email as its primary means of communication. Please provide us with the email address you use most frequently
Occupation*
Business Name
Business Phone
Mother's Name*
First Last
Mother's Hebrew Name ( if known)*
First
Mother's Cell*
Mother's Email*

Please note that Camp Chabad uses email as its primary means of communication. Please provide us with the email address you use most frequently
Occupation*
Business Name
Business Phone
Marital Status (choose one option)*
- Married
- Separated
- Widowed
- Divorced
Does your child have any allergies or other medical condition, require medication, or any special abilities or disabilities we should be aware of?*
- Yes
- No
Please describe them and indicate special precautions or care needed.
Small Wonders (Birth - 18 Months)
- Full Day 6:30 AM - 7:00 PM ( Please specify hours below)
- Half Day 9:00 AM - 3:00 PM
Torah Tots (18 Months - 3 Years Old)
- EZPASS ( Please specify hours below)
- Full Day 9:00 AM- 3:00 PM
- Half Day 9:00 AM - 12:30 PM
Mitzvah Munchkins (3 Years Old - 5 Years Old)
- EZPASS ( Please specify hours below)
- Full Day 9:00 AM - 3:00 PM
- Half Day 9:00 AM - 1:00 PM
Which session will your child be attending camp?
- Childcare Session June 22nd-June 26th
- Week 1 June 29- July 3 (Closed July 3rd)
- Week 2 July 6 - July 10
- Week 3 July 13 - July 17
- Week 4 July 20 - July 24
- Week 5 July 27 - July 31
- Week 6 August 3 - August 7
- Week 7 August 10 - August 14
- Week 8 August 17 - August 21
Which days of the week would you like to register your child?
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Before/ After Care? ( Any hours before 9 am and after 3 pm)
- Yes
- No
If you are registering for EZPASS or any before/after care hours, please indicate all days and hours of childcare needed.
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Monday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Tuesday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Wednesday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Thursday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Friday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
In order for your child to start, we need the most current Health and Immunization forms on file. (If we have it from the 2022/23 CELC school year, you do not to resend it. ) Please email us if you need a new Universal Health Record form to fill out.
We look forward to a wonderful, safe and happy summer!

CAMP ADMISSIONS FORM

The dates for Camp Chabad Summer 2025 are June 23 – August 15 ( We will be closed for July 4th)

There is a childcare option for the week in between school and camp, June 16 – June 20

The childcare week after camp, August 18-22 will be dependant on interest and availability.

CELC will be closed from August 25 – August 29 for Teachers In Service Week

Please fill out the form below to begin the camp application process.

Child Name*
First Last
Hebrew Name (If Known)
How Should Your Child Be Called?
Gender*
- Boy
- Girl
DOB*
MM slash DD slash YYYY
Time Of Birth
Age*
Home Phone*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Parent Information
Father's Name*
First Last
Father's Hebrew Name ( if known)*
First
Father's Cell*
Father's Email*

Please note that Camp Chabad uses email as its primary means of communication. Please provide us with the email address you use most frequently
Occupation*
Business Name
Business Phone
Mother's Name*
First Last
Mother's Hebrew Name ( if known)*
First
Mother's Cell*
Mother's Email*

Please note that Camp Chabad uses email as its primary means of communication. Please provide us with the email address you use most frequently
Occupation*
Business Name
Business Phone
Marital Status (choose one option)*
- Married
- Separated
- Widowed
- Divorced
Does your child have any allergies or other medical condition, require medication, or any special abilities or disabilities we should be aware of?*
- Yes
- No
Please describe them and indicate special precautions or care needed.
Small Wonders (Birth - 18 Months)
- Full Day 6:30 AM - 7:00 PM ( Please specify hours below)
- Half Day 9:00 AM - 3:00 PM
Torah Tots (18 Months - 3 Years Old)
- EZPASS ( Please specify hours below)
- Full Day 9:00 AM- 3:00 PM
- Half Day 9:00 AM - 12:30 PM
Mitzvah Munchkins (3 Years Old - 5 Years Old)
- EZPASS ( Please specify hours below)
- Full Day 9:00 AM - 3:00 PM
- Half Day 9:00 AM - 1:00 PM
Which session will your child be attending camp?
- Childcare Session June 22nd-June 26th
- Week 1 June 29- July 3 (Closed July 3rd)
- Week 2 July 6 - July 10
- Week 3 July 13 - July 17
- Week 4 July 20 - July 24
- Week 5 July 27 - July 31
- Week 6 August 3 - August 7
- Week 7 August 10 - August 14
- Week 8 August 17 - August 21
Which days of the week would you like to register your child?
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Before/ After Care? ( Any hours before 9 am and after 3 pm)
- Yes
- No
If you are registering for EZPASS or any before/after care hours, please indicate all days and hours of childcare needed.
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Monday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Tuesday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Wednesday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Thursday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Friday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
In order for your child to start, we need the most current Health and Immunization forms on file. (If we have it from the 2022/23 CELC school year, you do not to resend it. ) Please email us if you need a new Universal Health Record form to fill out.
We look forward to a wonderful, safe and happy summer!

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CAMP APPLICATION

CAMP ADMISSIONS FORM

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CAMP ADMISSIONS FORM

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