Register Online! | Dollard Jewish Day Camp

Online Registration!

Please fill out the form below carefully. When you press submit, this form will be sent to our administration office.

Note: Please use a separate form for each child.

Camper/Parent Information
Name		First	Middle	Last
Address		Street	City	Province	Post Code
Date of Birth
Email		Email
Schools		School	Hebrew School	Entering Grade:
Child's Mother		Mother's Name	Hebrew Name	Work Phone	Cell
Child's Father		Father's Name	Hebrew Name	Work Phone	Cell
Emergency Contact Info		Name	Phone	Relationship
Pediatrician		Name	Phone

Select Child's Age Group
	Age:

Please indicate number of sessions your child will attend camp:

		Comments:
IMPORTANT
•	All forms must be completed and submitted before your child begins camp.

	Date of Application: