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Winter Camp Registration - TK-8

Child Information:
First Name
Last Name
Child's Date of Birth (mm/dd/yyyy)
grade
Gender
 Male
 Female
Zip
Parent's name(s)
Email
Phone
Address
City
State

Payment Details:
Please select which camp you are signing up for
If you are registering by week, please select the appropriate option:

Member (Grades TK - 5) price per day: $90

If you are signing up per day please select which days your camper will attend
 Monday Dec. 24
 Wednesday Dec. 26
 Thursday Dec. 27
 Friday Dec. 28
 Monday Dec. 31
 Wednesday Jan. 2
 Thursday Jan. 3
 Friday Jan. 4

Public (Grades TK - 5) price per day: $95

If you are signing up per day please select which days your camper will attend
 Monday Dec. 24
 Wednesday Dec. 26
 Thursday Dec. 27
 Thursday Dec. 28
 Monday Dec. 31
 Tuesday Jan. 2
 Wednesday Jan. 3
 Friday Jan. 4

Member (Grades 6-8) price per day: $53

If you are signing up per day please select which days your camper will attend
 Monday Dec. 24
 Wednesday Dec. 26
 Thursday Dec. 27
 Friday Dec. 27
 Monday Dec. 31
 Wednesday Jan. 2
 Thursday Jan. 3
 Friday Jan. 4

LIT Public (Grades 6 - 8) price per day: $63

If you are signing up per day please select which days your camper will attend
 Monday Dec. 24
 Wednesday Dec. 26
 Thursday Dec. 27
 Thursday Dec. 28
 Monday Dec. 31
 Wednesday Jan. 2
 Thursday Jan. 3
 Friday Jan. 4
Grand Total

Payment Information:
I am a member, charge my card on file
Card Type
Name on Card
Credit Card Number
CVV (located on back of card)
Expires (mm/yy)

The Merage JCC is a 501(C)(3) non-profit organization and all contributions are tax deductible to the full extent of the law. The JCC Federal Tax ID number is 330016661.