Camp Habima 2020 Registration Form
(for girls in grade 6 and older) For more info about us click here.
LOCATION: Young Israel of Passaic-Clifton (200 Brook Avenue, Passaic, NJ 07055)
DATES: Wednesday, July 22nd - Wednesday, August 19th, 2020 (final performance will be on the evening of August 19th)
SCHEDULE: MONDAY-THURSDAY - 9:30-3:30 FRIDAY - 9:30-1:00
TUITION: EARLY BIRD SPECIAL (AVAILABLE UNTIL FEBRUARY 10th, 2020 only): $1100
***** All tuition payments with checks dated as per schedule below including final check dated NO LATER than June 1st,2020 must be received by February 10th to receive the EARLY BIRD tuition discount. ANY INCOMPLETE APPLICATIONS OR THOSE SUBMITTED WITHOUT CHECKS FOR FULL TUITION BALANCE WILL BE BILLED AT THE REGULAR TUITION RATE.
AFTER FEBRUARY 10th: $1300
PAYMENT DEADLINES (Payment may be divided into 3 parts. $250 deposit due by March 15th, 2020):
1. March 15th - $250 (non-refundable deposit, submitted with REGISTRATION FORM)
2. April 15 - second installment of $250 due
3. June 1 - Final payment (FULL BALANCE) due. NO EXCEPTIONS.
· The $250 deposit is not refundable. No camp fees will be refunded after June 1st.
· A Universal Health Form will be emailed to you upon receipt of deposit.
· Registration is complete when all forms and payments have been received.
1. DOWNLOAD, PRINT and COMPLETE registration form. HARD COPIES OF ALL REGISTRATION MATERIALS ARE REQUIRED.
2. Include $250 deposit (CASH/CHECK only; checks should be made out to Paula Jacobs (ONLY) with "CAMP HABIMA" in the memo line of the check)
3. MAIL TO: Paula Jacobs c/o Camp Habima (125 Van Houten Ave, Passaic, NJ 07055)
Child's Last Name:
Child's First Name:
Date of Birth (month, date, year):
Grade Entering September 2020:
Home Phone Number:
Mother's Name: Mother's Cell/Work Number:
Father's Name: Father's Cell/Work Number:
Does your child have any allergies or health, developmental or behavioral concerns?
If yes, please specify:
In case of emergency, if a parent cannot be reached, who can we contact?
Child's Physician: Child's Dentist:
Medical Waiver: In case of a medical emergency, when a parent cannot be reached or time is of the essence, I hereby authorize a
Camp Habima senior staff member or their representative to act as my agent, with respect to said minor and to seek proper medical attention and make medial decisions on behalf of my child.
Photo Waiver: I am aware that photos and videos may be taken of my child during the day at Camp Habima and during off site activities. I am aware that these pictures may be used for advertising, illustrating and promoting camp activities.
By registering my child at Camp Habima, I am granting permission for my child to participate in all onsite activities on camp premises and all off camp premises activities.
Tznius Guidelines: All campers must wear sleeves that cover the elbow and skirts below the knee. Socks are to be worn and collarbones should be covered.
Dietary Guidelines: As some participants and other children on the premises may have nut allergies, we request that snacks and lunches be nut free at Camp Habima.
Registration will be confirmed via email and will be limited based on space available.
Thank you for registering for Camp Habima...where every girl is a star!