BJE Teen Service Corps Summer 2024 Camp Registration Form

BJE Teen Service Corps will be hosting 2 sessions this summer! Camp will take place Monday-Friday from 9:00- 3:00pm.

Session 1: June 24-28 based at Temple Judea

5429 Lindley Ave, Tarzana, CA 91356

Session 2: July 29-August 2 based at Temple Israel of Hollywood
7300 Hollywood Blvd, Los Angeles, CA 90046

If you have any questions, please reach out to Lily Khalili lkhalili@bjela.org

Camper Information

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone number

Camper's Age

Gender(Male, Female, Self-Describe)

Does the camper have any allergies (please list below)?

Which session are you registering for?

Authorized person for pick up (in addition to the Emergency contact)

Emergency Contact Information #1

Emergency Contact's First Name	Emergency Contact's Last Name
Relationship to Camper	Contact Number

Emergency Contact Information #2

Emergency Contact's First Name	Emergency Contact's Last Name
Relationship to Camper	Contact Number

Payment

Amount per camper is $625 ($575 Early Bird Discount if registered by April 15, 2024)

$50 Sibling Discount

BJE will issue invoice for 50% of applicable program fee to the email address provided during registration. Payment is due within 7 days of receiving the invoice. A second invoice for the remaining balance will be issued on May 21, 2024. Payment is due within 7 days of receiving the second invoice. Late payments, cancellations, and administrative fees are detailed in the waiver to be submitted.

Total Amount:

.00

Informed Consent and Acknowledgement

I understand that this form does not mean my child is registered. Final registration will include that all medical and transportation forms are submitted by June 1, 2024.

Yes, I agree

Contact Information