Winter Camp Registration 2023 - JewishBallantyne.com

Your total tuition cost is due at the time of registration and is non-refundable.
Tuition is $80 per day or $340 for the week

PLEASE NOTE: Winter Camp 2023 will take place at Charlotte Allstar Gymnastics & Cheerleading. 11011 Monroe rd. A bus will be offered from BJC leaving at 9:00 AM and returning at 3:30 PM.
Mother's Name

First Name Last Name
Father's Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
E-mail
Child 1

First Name Last Name
Birth Date

Month Day Year
Current School
Current Grade
Gender
Child 2

First Name Last Name
Birth Date

Month Day Year
Current School
Current Grade
Gender
Child 3

First Name Last Name
Birth Date

Month Day Year
Current School
Current Grade
Gender
Emergency/Health Information
In case of emergency and we are unable to contact a parent, please write two individuals that can be contacted.
Name/Phone Number/Relationship to Child
Name/Phone Number/Relationship to Child
Do any of your children who are attending have any allergies or dietary restrictions? If yes, please explain and specify which child
Do any of your children that are attending have any health issues that we need to be aware of? If yes, please explain and specify which child
Choose your registration options. Tuition is $80 per day OR $340 for all five days.

Monday, December 25thTuesday, December 26thWednesday, December 27thThursday, December 28thFriday, December 29thAll Five Days
If you are registering more than one child, and they will be attending different days of camp, please clarify here:
Total tuition costs are due at the time of registration.
As the parent(s) or legal guardian(s) of child noted above, I/we authorize any adult acting on behalf of the Ballantyne Jewish Center/Camp Gan Israel Ballantyne, to hospitalize or secure treatment for my child. I further agree to pay for all charges for that care and/or treatment. It is understood that, if time and circumstances reasonably permit, the camp will try to communicate with me prior to such treatment.

I/we hereby give permission for my child/ren to attend all field trips and outings sponsored by the Ballantyne Jewish Center/Camp Gan Israel Ballantyne and be transported to and from the field trips and outings. I also allow my child to photographed while participating in camp activities. I/we understand that these photographs may be used for publicity purposes.
Parents Names
Date
Please fill out the total amount of tuition due. This payment is non-refundable.
If you need to make a payment plan please contact Rabbi Levin, [email protected]
Total Tuition:*

$
Total Payment:

$0.00

Payment*

Credit Card Paypal

Postal / Zip Code

Country

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