Camp Registration

PARENT INFORMATION

Parent 1

* Parent 1: First Name

* Parent 1: Last Name

* Parent 1: Email Address

* Parent 1: Phone

Parent 2

Parent 2: First Name

Parent 2: Last Name

Parent 2: Email Address

Parent 2: Phone

Household Address

* Address 1

Address 2

* City

* State

* Zip Code

CHILD INFORMATION

How many children are you registering for camp?

Child 1

* Child 1: First Name

* Child 1: Last Name

* Child 1: Date of Birth

Child 1: Allergies

Child 1: Is there anything else we should know about your child?

Child 2

Child 2: First Name

Child 2: Last Name

Child 2: Date of Birth

Child 2: Allergies

Child 2: Is there anything else we should know about your child?

Child 3

Child 3: First Name

Child 3: Last Name

Child 3: Date of Birth

Child 3: Allergies

Child 3: Is there anything else we should know about your child?

Child 4

Child 4: First Name

Child 4: Last Name

Child 4: Date of Birth

Child 4: Allergies

Child 4: Is there anything else we should know about your child?

Permission, Release & Waiver of Liability:
By completing this enrollment form and entering my digital signature below, I as the parent or legal guardian of the above child(ren) hereby release Hollywood Torah Center from any and all liability arising from claims for injuries or damages that either individually or on behalf of my child might occur during participation in Camp l activities. I authorize any adult acting on behalf of Hollywood Torah Center program to treat, hospitalize, or secure treatment for my child. I further agree to pay all charges for that care and/or treatment. I hereby give permission for my child to participate in all camp activities and field trips. I understand that my child may be photographed while participating in Hollywood Torah Center activities and that these pictures may be used for marketing purposes. By electronically signing my name below, I accept these terms and conditions.

* I agree

I agree

* First Name

* Last Name

Total Charges

Camp Registration 2025