One form per camper please
Camper Name _________________________________________ Address ______________________________________________ Parent # 1 Name _______________________________________ Phone ( H )____________________ ( W )____________________ Cell Phone ___________________________________________ Primary E-Mail _______________________________________
D . O . B . ___/___/___ Grade ( as of Aug . 2017 ) ____ Gender _________ City / State / Zip _________________________________________ Parent # 2 Name _______________________________________ Phone ( H )____________________ ( W )____________________ Cell Phone ___________________________________________ JCC Member : Yes ______ No ______
Two Week Sessions
One Week Sessions
* Week S1A May 30- June 2
Week S1B June 5-9
Week S2A June 12-16
Week S2B June 19 - 23
Week S3A June 26 — 30
** Week S3B July 3 - 7
Week S4A July 10 -14
Week S4B July 17 - 21
Week S5A July 24 — 28
Week S5B July 31-Aug . 4
Camp Tiyul ( 6-9 ) � � � � � � � � � �
ACC-Athletic Conditioning ( 6-9 ) � � � � � � � � � � Camp Bonim L . I . T . ( 9-12 ) � � � � � � � � � �
JCCA Shalom Malibu ( 4-11 ) Week S2A resident in Malibu
* Morning Specialty Camps 9 am . - 12:15 pm
* Afternoon options below . See fees on Specialty Camps Page
�Tennis
�S . Y . STEM
�Tennis
�Bricks 4 Kidz
�Tennis
�
Photography
�Tennis
� Drawing Studio Art
�Tennis
�Evolve Martial Arts
�Tennis �Minecraft Explorer �Cooking
�Tennis �Parkour �Chess
�Tennis
�Wright Flight
�Tennis
�Pottery
�Tennis
�Joy of Coding Jr .
Camp Sababa ( half day ) * add-on to specialty : 12:15-4 pm
� � � � � � � � � �
AM Care Specialty $ 33m /$ 38nm PM Care Sababa $ 33m /$ 38nm
Session One May 30-June 9
�7-9 am �4-6 pm
Session Two June 12 — 23
June 12-16 - See page 9 for details
�7-9 am �4-6 pm
�7-9 am �4-6 pm
Session Three June 26-July 7
�7-9 am �4-6 pm
� Pre-payment In Full ( with check payable to TJCC or provide CC info )
� Summer Payments Questions , please contact Andrea Wright at 520-299-3000 , x103 . Inquiries for Inclusion and DDD registration , please contact Emily Malin at 520-299-3000x168 .
Select One :
� Electronic Funds Transfer ( attach voided check )
� Credit Card On File
� Check here if already on file with The J Please indicate last 4 digits __________ exp . date ______
� Visa / MC / Discover Card #_________________________ exp . date ______ 3-Digit Code ( from back of CC )____________
Session Four July 10 — 21
�7-9 am �4-6 pm
�7-9 am �4-6 pm
�7-9 am �4-6 pm
�7-9 am �4-6 pm
�7-9 am �4-6 pm
�7-9 am �4-6 pm
� JCC Member , � Non-Member * Fees are on ECE page
� Early Bird ( All Camps ) by 3 / 31 / 17 $ ___________
Registration Information Non-refundable deposits are required with registration forms . There is a one-time $ 30 enrollment fee for each child , plus $ 20 for each child for each session of camp ( will apply to camp fee ). Please mail or bring registration form to the Tucson J , 3800 E . River Road , Tucson , AZ 85718 . Scholarship requests due March 31 , 2017 . For cancellation and other policies , see camp inserts . Payment option must be submitted with registration . The Camp Registrar will send an e-mail confirmation , state health forms , parent handbook , and intake forms . Additional registration forms are available at tucsonjcc . org . All schedules and programs are subject to change . Your signature below acknowledges that you have reviewed the Camp J Registration Page and understand camp policies ( see parent handbook ) and the refund / cancellation policy _____ ( initial ). I , the undersigned , understand that participation in any JCC activity and use of recreational and workout facilities involve a risk of accidental injury despite all safety precautions . Therefore , as a parent and / or guardian , I will assume all risks ( injury or illness ) for my children and family members that may occur during participation in any activities or use of facilities at the JCC or on JCC supervised field trips . In case of sudden injury or illness , I hereby give authority to any hospital or doctor to render immediate aid as may be required at the time for my child ’ s health and safety . I authorize staff to apply sunscreen to avoid sunburn . I give permission for my child to swim in the JCC pool . I give permission for my child to attend JCC supervised field trips , and for photographs to be taken and used privately and / or in JCC publications . I understand medical expenses are my responsibility . In the event that my child needs medical treatment due to an accident , injury or natural causes while registered for JCC programs , I authorize the JCC personnel to take whatever action is necessary to care for my child . I hereby give permission for JCC personnel to use their judgment in arranging for my child ’ s emergency medical treatment in addition to contacting me to the best of their ability . I certify that my child is fully covered by medical insurance and that I am fully responsible for all costs incurred due to medical or dental treatment as deemed necessary by JCC personnel . By signing this form , I acknowledge that I am aware of the potential risks of participating in activities and / or programs at the JCC , and agree to in no way hold the management , agent or employees of the JCC liable for any injury that my children may sustain . I have read and understand the above statement . Camp fees due Friday prior to session .
OR
Session Five July 24-Aug . 4
Camp Shalom ( K-2 ) � � � � � Camp Giborim ( 3-5 ) � � � � � Ultimate Sports ( 3-5 ) � � � � � Pre-Care , 7-9 am � � � � � Post-Care , 4-6 pm � � � � �
Northwest Tucson Transportation : Yes ____ No ____
� One week stand alone
� Add-on to Camps ’ Giborim or Sports
* JCC and Camp Closed Week S1A on May 29 and 31 . ** JCC and Camp Closed Week S3B for July 4
Camp Name
H2Oasis Camp ( K-6 ) Pre / Post
� Subtotal ( All Camps ) after 3 / 31 / 17
Pre / Post Camps
5 / 25� 5 / 26� 8 / 07� 8 / 08� 8 / 09�
Parkour ( 2-6 ) 5 / 25� 5 / 26� Pottery ( 2-6 )
Extend Day 7 a . m . to 6 p . m .
8 / 07� 8 / 08� 8 / 9�
5 / 25� 5 / 26� 8 / 07� 8 / 08� 8 / 09�
$ ___________
Yes , I would like to help Send a Kid to Camp .
My tax deductible donation is : � $ 36 � $ 72 �Other $___________
One-time Enrollment Fee ( does not apply to travel / pre / post-camps ) $ 30.00 Total $___________
Will you be sending multiple children to camp ? Yes ___ No ____
** For Members : All siblings receive a 5 % discount at time of registration .
Sign Here _________________________________________________________________________________________ Date __________________________