Camper Information Form

215-698-7300

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(current)

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Camper Information form

Camper Name *

Gender *

Girl

Boy

Birth Date *

Age as of 6/1/2024 *

Address *

City *

State *

Zip Code *

Primary Phone Number *

Grade starting September 2024:

Parent Information

Adult #1 *

Parent

Step Parent

Guardian

Other

Relation

Name *

Email *

Phone Number *

Adult #2 *

Parent

Step Parent

Guardian

Other

Relation

Name *

Email *

Phone Number *

Camp Options

Age Group *

Camp Sessions *

2024 Camp Prices

	9 Weeks	8 Weeks	4 Weeks
Lower Camp, Maccabi, Sr. Girls & CIT	$2,565	$2,280	$1,140
Payment Option	Full	Full	Full

Price is based on $285/week and must be paid before 6/17/24.

Payment Method

ELRC (formerly CCIS)

Private Pay

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10100 Jamison Avenue, Philadelphia, PA 19116
Phone : 215-698-7300
Fax : 215-673-7447