HHD Camp, Youth & Family Services, & Babysitting Registration 5785/2024 - Form

High Holy Days Registration

Babysitting
(18mo-5yrs)
*Cost associated will be collected when form is submitted.

High Holy Day Camp
(Grades K-7)

Youth & Family Services
Dor Chadash Services (Infants-Pre-K)
Bonim Services (Grades K-3 and 4-7)

Parent/Guardian 1

* First Name

* Last Name

* Cell

* Email

Parent/Guardian 2

First Name

Last Name

Cell

Authorized Alternative Pick Up

If anyone other than those listed on this form are authorized to pick up your children, please list them below:

First and Last Name

Mobile

Relationship

First and Last Name

Mobile

Relationship

Which Shearith Youth & Family program are you registering for?

BABYSITTING (18mo-5 yrs)

Pre-registration is required as walk-ins cannot be accommodated.
Questions? Contact Taylor Hayden at thayden@shearith.org

1 Child
$15 per service

Each Additional Child
$5 per service

Number of children

Child 1

* First and Last Name

* Age

* Number of HHD services needed

Please provide any special needs, diagnosis, allergies, or anything else we may need to know.

Child 2

* First and Last Name

* Age

* Number of HHD services needed

Please provide any special needs, diagnosis, allergies, or anything else we may need to know

Child 3

* First and Last Name

* Age

* Number of HHD services needed.

Please provide any special needs, diagnosis, allergies, or anything else we may need to know.

Child 4

* First and Last Name

* Age

* Number of HHD services needed

Please provide any special needs, diagnosis, allergies, or anything else we may need to know.

Child 5

* First and Last Name

* Age

* Number of HHD services needed

Total Due for Babysitting

YOUTH & FAMILY SERVICES

Questions? Contact Taylor Hayden at thayden@shearith.org

* Will you be attending with your child(ren)?

Please Select OneYesNo

* Do you already have HHD tickets for Aaron/Beck/Kaplan for the same day(s) that you plan to attend Family Services? (If so, you will not need Family Service tickets but will still need to register.)

Please Select OneYesNo

* Please select which Youth & Family Service(s).

RH Day 1 Dor Chadash (Infants - Pre-K) 9:00-9:45am in Topletz AuditoriumRH Day 1 Bonim (Grades K-3) 10:00-10:45am in Topletz AuditoriumRH Day 1 Bonim (Grades 4-7) 10:00-10:45am in Fonberg Family ChapelRH Day 2 Bonim (Grades K-7) 10:00-10:45am in Fonberg Family ChapelYom Kippur Dor Chadash (Infants - Pre-K) 9:00-9:45am in Topletz AuditoriumYom Kippur Bonim (Grades K-3) 10:00-10:45am in Topletz AuditoriumYom Kippur Bonim (Grades 4-7) 10:00-10:45am in Fonberg Family Chapel

* Number of children attending

Child 1

* First and Last Name

Child 2

* First and Last Name

Child 3

* First and Last Name

Child 4

* First and Last Name

Child 5

* First and Last Name

High Holy Day Camp (K-7)

Questions? Contact Sandi Burt at sandib@shearith.org

* Which days will your child(ren) be attending HHD Camp?

* Number of children registering for HHD Camp?

Child 1

* First and Last Name

* Age

* Grade

Please provide any special needs, diagnosis, allergies, or anything else we may need to know

Child 2

* First and Last Name

* Age

* Grade

Please provide any special needs, diagnosis, allergies, or anything else we may need to know.

Child 3

* First and Last Name

* Age

* Grade

Please provide any special needs, diagnosis, allergies, or anything else we may need to know.

Child 4

* First and Last Name

* Age

* Grade

Please provide any special needs, diagnosis, allergies, or anything else we may need to know.

Child 5

* First and Last Name

* Age

* Grade

Please provide any special needs, diagnosis, allergies, or anything else we may need to know.

Do you have any children age 14 or older who are interested in volunteering to help at HHD camp? If so, please list their names below.