BJE Teen Service Corps 2015

Choice of Session

Camper Information














About Camper

Information in this section will be used to help us understand the needs of our campers, and plan accordingly.















Camper 2 Information (if only enrolling one camper, please skip to Parent/Guardian Information)










About Camper 2

Information in this section will be used to help us understand the needs of our campers, and plan accordingly.















Parent/Guardian I Information
Please note that our office will use Parent/Guardian 1 as the first contact for all emails, forms, and communications. Please let us know if you want us to send communications to both Parents/Guardians.









Parent/Guardian II Information









Emergency Contact Information







Registration is $315 per camper enrolled prior to April 30, 2015, and $340 after, with a $25 sibling discount.

To apply for a scholarship, please contact Camp Director Alisha Pedowitz at apedowitz@bjela.or following completion of this registration form.

Payment can be made via check or credit card through PayPal.





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