2026 Camp Application - Camp begins June 22, 2026

Application without Payment or Payment without Application does NOT guarantee space.

Full Name*

First Name Last Name

Nickname?*

Teen's Cell Phone*

Country Code Area Code Phone Number

Birth Date*

Month Day Year

Gender*

MaleFemale

School?*

Current Grade?*

T-Shirt Size?*

Upload photo of camper*

Camp week(s)*

Week 1Week 2Week 3Week 4

Primary contact?*

MotherFather

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Marital Status?*

How did you hear about us?*

Any adoption or conversion in the family?*

If yes please explain:

Father's Full Name*

First Name Last Name

Father's E-mail*

Father's Phone Number*

Country Code Area Code Phone Number

Father's Address If different than above

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Mother's Full Name*

First Name Last Name

Mother's E-mail*

Mother's Phone Number*

Country Code Area Code Phone Number

Mother's Address if diffrent than above

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Is Mother Jewish?*

We accept conversions recognized by the rabbinical courts in Israel (Rabanut of Israel).

If converted, please elaborate

Emergency Contact Name*

First Name Last Name

Work/Mobile Phone*

Country Code Area Code Phone Number

I hereby give my consent for emergency medical treatment, to be used only if I cannot be reached immediately.*

Initialize

I hereby give permission for my child to be transported and participate in field trips during operating hours. Details will be sent to me in advance*

Initialize

List any Sensitivities your child has. Any dislikes you feel we should be aware of?

Does your child have any allergies?*

If yes, please list allergies

Does your child have any medical issue?*

NoYes

If yes please explain

Please describe any instructions that would be helpful in caring or for your child, or special medical information needed by the child’s care staff/provider.

Code of Conduct - click here to read

I have read these rules and reviewed them with my child and understand them fully. We certify that my child will adhere to this code. We understand that any violation of this Code of Conduct may result in me being suspended from camp. By signing below, we confirm we have read and understand the Code of Conduct fully.

Confirm (parent)*

Parents signature for Code of Conduct

Confirm (camper)*

Campers signature for Code of Conduct

For more camp info, click here

$550 Early-bird through Feb 28
$600 Weekly price after March 1
$660 After May 1st, registration closes and you will be on wait list

Scholarships maybe available. Please D.M.425-786-6587 to check availability.

Cancellation fee: $100 non-refundable

Refunds: All refunds will be charged a 3% administrative fee for credit card payments.

Camp Application

Camp begins June 22, 2026

2026 Camp June 22 - July 13, 2026

1. Camper Info

2. Family Info

3. Emergency Contact

4. Parental Consent and Transportation Information

5. Code of Conduct

Camp Fee, Deadline & Payment

Synagogue Services

Community Programs

Women's Events

Shorashim Sundays

Mikvah

Gift Shop