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Parent/Guardian Full Name:

 

Address:


City:


State:

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Zip:


Home Telephone:


Cellular Telephone:


Parent/Guardian Email:


Child # 1 Full Name:


Child # 1 Sex:

  Male Female

Child # 1 Age:


Child # 1 Grade (that child will finish just before starting camp):
 

Has This Child Attended a Jewish Sleepaway Camp before?

  Yes No

If Yes, for how long?
 

Child # 2 Full Name:


Child # 2 Sex:

  Male Female  

Child #2 Age:
 
 

Child # 2 Grade (that child will finish just before starting camp):


Has Your Child Attended a Jewish Sleepaway Camp before?

  Yes No

If Yes, for how long?
 

Child # 3 Full Name:


Child # 3 Sex: (dropdown choice of Male or Female)

  Male Female

Child # 3 Age:


Child # 3 Grade (that child will finish just before starting camp):


Has Your Child Attended a Jewish Sleepaway Camp before?

  Yes No

If Yes, for how long?
 

Jewish Family?  

  Yes No


Do you need scholarship information?

Yes No  

How did you hear about Surprise Lake Camp? 

  Internet Search Friend Family Member Alumni Another SLC Family Camp Fair Advertisement

Please  specify if applicable:
 

Are you interested in a home visit?

  Yes No

Additional Notes: