2024 Simcha Summer Camp Registration

Hello Simcha Campers!

We are so thrilled that you want to join us for our second annual Simcha Summer Camp experience taking place right here on our Shomrei Torah campus! Please carefully read the information below, and make your selections based on your preferences.

The full tuition of Camp is due at the time of registration.

Tuition includes a camp t-shirt, cost of all field trips, and two snacks per day. If you are unable to pay the full amount of tuition at this time or have applied for scholarship but would not like to lose your place, please email Lara Brown at lara@cstsr.org

Please pack your child a lunch each day without pork or shellfish
Refer to our Kashrut Policy for more information

Any questions can be directed to Lara Brown by calling the front desk at (707) 578-5519.

Please fill out one form per camper if you are signing up multiple children!

For more information on camp, the schedule, and/or curriculum, please visit the Simcha Summer Camp web page by CLICKING HERE

Family Contact Information

Adult #1 Contact Information

* First Name (Primary)

* Last Name (Primary)

* Email (Primary)

* Phone (Primary)

* Relationship to Camper

* Street Address (Primary)

* City (Primary)

* State (Primary)

* ZIP Code

Is there a second parent or adult to add?

Adult #2 Contact Information

First Name (Secondary)

Last Name (Secondary)

Email (Secondary)

Phone (Secondary)

Relationship to Student(s)

Street Address (Secondary)

City (Secondary)

State (Secondary)

ZIP Code (Secondary)

Emergency Contact Information

Please enter an adult (other than Parent 1 or Parent 2 listed above) whom we may contact in an emergency if parents cannot be reached.

* Emergency Contact First & Last Name

* Emergency Contact Phone Number

* Emergency Contact Relationship to Student(s)

Emergency Contact First & Last Name

Emergency Contact Phone Number

Emergency Contact Relationship to Student(s)

Synagogue Affiliation

* Are you a member of a Sonoma County Synagogue?

* Please type the name of the Synagogue with which you are a Member

Camper Information

* Camper First Name

* Camper Last Name

* Camper Birthdate

* Camper Grade in School

* Camper T-shirt size

* Camper Name of Secular School

* Does this camper have special learning needs?

Special Needs Details

Please describe special needs we will need to be aware of during Camp activities. We would like to meet with you before summer camp begins so that we are able to discuss the best ways to support your child.

* Does this camper have serious allergies, food intolerances or medications that they will need during religious school sessions?

Allergy/Medication Details

Please describe only allergies and medications we will need to be aware of during Camp activities.

Camp Session Selection

* How many weeks would you like to enroll for Summer Camp?

Please note that full camp tuition is due at the end of the registration process. If you are unable to pay the full tuition or would like to apply for scholarship, please reach out to Lara Brown at lara@cstsr.org

* Please Select the Weeks of Attendance

Week 1 - 6/17/24 to 6/21/24Week 2 - 6/24/24 to 6/28/24Week 3 - 7/8/24 to 7/12/24Week 4 - 7/15/24 to 7/19/24

* How many Early Care Mornings would you like to purchase?

Early Care starts at 8:30 AM and goes until 9:00 AM. Each morning is $10 extra. Purchased Early Care can be redeemed on any day you are at camp and is not assigned to a specific day. Early care cannot be purchased for field trip days - Thursdays.

Medical Release

By signing my name below, my child(ren) have permission to participate in the Simcha Summer Camp program held by Congregation Shomrei Torah. I authorize Congregation Shomrei Torah staff to obtain emergency medical care for my child(ren) in the event such care is indicated. I understand that every effort will be made to notify a parent/guardian prior to treatment.

By typing my name in this box, I confirm I have read, understand and agree to the statement above.

* Preferred hospital in the event of an emergency

Please indicate which hospital you would like us to take your child(ren) to in the event of an emergency

* Preferred Hospital Address

Photo Release

From time to time your child’s photo may be taken in our classrooms or special events. Images of your student(s) taken at Simcha Summer Camp events might be published on the CST Facebook page, the CST website or the CST mailed publication "the VOICE". Children are never identified by name in publications.

* Do you give permission for your student to appear in these publications?

Pickup Permissions

* First and Last name of Authorized Pick-Up Adult

* Phone Number of Authorized Pick-Up Adult

First and Last name of Authorized Pick-Up Adult

Phone Number of Authorized Pick-Up Adult

First and Last name of Authorized Pick-Up Adult

Phone Number of Authorized Pick-Up Adult

Payment

Full payment is due at registration and is required by the first day of camp in order for your camper to attend. If you are unable to pay the full amount now or would like to apply for a scholarship, please contact Lara Brown at the front office (707) 578-5519

Total

Total Amount Due Today (The remaining tuition amount will be billed to your account)

Tue, May 7 2024 29 Nisan 5784

2024 Simcha Summer Camp Registration

Please fill out one form per camper if you are signing up multiple children!

For more information on camp, the schedule, and/or curriculum, please visit the Simcha Summer Camp web page by CLICKING HERE

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A Progressive Reform Jewish Congregation

2600 Bennett Valley Road, Santa Rosa, California 95404