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Child 1 Full Name *

Child 1 Preferred Pronouns

Child 1 Grade in Fall 2023 *

Child 2 Full Name

Child 2 Preferred Pronouns

Child 2 Grade in Fall 2023

Child 3 Full Name

Child 3 Preferred Pronouns

Child 3 Grade in Fall 2023

Is your family new to the Jewish Enrichment Center? If yes, please complete the Family, Health, and Emergency Information form. *

Yes

Parent/Guardian First and Last Name *

Parent/Guardian Preferred Pronouns *

Parent/Guardian Phone *

Parent/Guardian Email *

Registration Information

Week One (August 21 - 25):

Regular Day: 8:30 AM - 3:30 PM

Regular Day + Late Afternoon: 8:30 AM - 5:45 PM*

*Friday afternoon until 5:15 PM.

Week Two (August 28 - September 1):

Regular Day: 8:30 AM - 3:30 PM

Regular Day + Late Afternoon: 8:30 AM - 5:45 PM*

*Friday afternoon until 5:15 PM.

Single Day Registration. On what days are you enrolling your child(ren)?

Monday, Aug. 21 (8:30 AM - 3:30 PM)

Tuesday, Aug. 22 (8:30 AM - 3:30 PM)

Wednesday, Aug. 23 (8:30 AM - 3:30 PM)

Thursday, Aug. 24 (8:30 AM - 3:30 PM)

Friday, Aug. 25 (8:30 AM - 3:30 PM)

Monday, Aug. 28 (8:30 AM - 3:30 PM)

Tuesday, Aug. 29 (8:30 AM - 3:30 PM)

Wednesday, Aug. 30 (8:30 AM - 3:30 PM)

Thursday, Aug. 31 (8:30 AM - 3:30 PM)

Friday, Sept. 1 (8:30 AM - 3:30 PM)

Single Day Late Afternoons. On what days are you enrolling your child(ren)?

Late Afternoon on Monday, Aug. 21 (3:30 PM - 5:45 PM)

Late Afternoon on Tuesday, Aug. 22 (3:30 PM - 5:45 PM)

Late Afternoon on Wednesday, Aug. 23 (3:30 PM - 5:45 PM)

Late Afternoon on Thursday, Aug. 24 (3:30 PM - 5:45 PM)

Late Afternoon on Friday, Aug. 25 (3:30 PM - 5:15 PM*)

Late Afternoon on Monday, Aug. 28 (3:30 PM - 5:45 PM)

Late Afternoon on Tuesday, Aug. 29 (3:30 PM - 5:45 PM)

Late Afternoon on Wednesday, Aug. 30 (3:30 PM - 5:45 PM)

Late Afternoon on Thursday, Aug. 31 (3:30 PM - 5:45 PM)

Late Afternoon on Friday, Sept. 1 (3:30 PM - 5:15 PM*)

*Friday afternoon until 5:15 PM.

Does your child have any allergies? *

Yes

If yes, what are they? Please provide a current allergy action plan. *

Does your child have an Epi-Pen? If yes, please send it with your child. We can also keep one onsite. *

Yes

Got one child who's staying for Late Afternoon and another who's leaving at 3:30 PM? Children enrolling on different days? Let us know the details below.

Photo release: I grant permission for my child/ren's photo, without their name, to be included in Jewish Enrichment Center printed and online materials. *

Yes

Medical Permission: In the event that you cannot be reached, and in the judgement of the director or another staff member of the Jewish Enrichment Center, if there is a necessity for immediate examination or treatment of my child, I hereby authorize any of the aforesaid personnel to obtain for said child such medical services. *

I agree

If you do not agree, please contact us.

I hereby give permission for my child/children to take field trips supervised by the Jewish Enrichment Center during August Enrichment Camp. I understand that I will receive advance notice regarding the details of the field trip. *

I agree

If you do not agree, please contact us.

As a condition of my child's/children's participation in Jewish Enrichment Center's August Camp, I agree to waive any claim and to hold the Jewish Enrichment Center harmless for additional injuries to my child/children provided that the Jewish Enrichment Center has acted with reasonable care to provide safe conditions and adequate supervision for all activities during the day. *

I agree

If you do not agree, please contact us.

By checking the box below, I confirm that all the information in this form is correct and that I understand the tuition commitments and deadlines associated with enrolling my child/ren. *

Yes! Enroll my child/ren.

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Registration Information

In this section

Phone: 708-529-5237

Register now!

Registration Information

In this section

Phone: 708-529-5237

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