CBS Camp Chaverim Registration 2023

Camp Chaverim 2023 will take place from Mon. June 26 to Fri. July 7 (please note-- no camp on Tues. July 4). We hope your children can come for one or both weeks! We'll have a different theme and different activities each day of camp.

Week 1 is very close to full, so all requests to register for Week 1 must now go through the waiting list! If you would like to register your camp for week 1, please indicate that you would like your child to be on the waiting list, and we will verify that there is space before registering your child.

Register before 11:59 pm on March 31st for the Early Bird discount and save $25 a week!

Please note that all requests for refunds must be made by June 1st. We cannot give a refund after that date.

Remember to log into your CBS account before filling out this form if you wish to bill to your CBS account and set up a payment plan!

Adding Extended Care after Initial Registration

If you have already registered your child for camp and ONLY need to add on extended care, please indicate that below, to skip the questions on contact information, medical information, etc. If you have not yet registered your child for camp, you may skip this question.

Skip this question if you have not yet registered your child for camp! If you are adding extended care after you have already registered your child for camp, answer the question below:

Please select one.I have already registered my child for camp and ONLY need to add on extended care.I need to register my child for camp.

Camper Information:

* First Name:

* Last Name:

* Birthday:

* Grade in Fall of 2023

* Address:

* City:

* Zip

What is most important about your child’s experience at Camp Chaverim?

Please share anything you feel is important for us to know about your child for their optimum experience:

Is there anything else you would like us to know about your child?

Parent #1 Information:

* First Name:

* Last Name:

* E-mail:

Home #:

* Cell #:

Work #:

Parent #2 Information:

First Name:

Last Name:

E-mail:

Home #:

Cell #:

Work #:

Emergency Contact Information:

Person(s) OTHER THAN PARENTS/GUARDIANS in case parents are unable to be reached.

* Emergency Contact Name:

* Emergency Contact Phone Number:

Emergency Contact Name:

Emergency Contact Phone Number:

Person(s) OTHER THAN PARENTS authorized to pick up camper:

Pick Up Contact Name:

Pick Up Contact Phone Number:

Pick Up Contact Name:

Pick Up Contact Phone Number:

Medical Information:

Physician:

Phone:

Dentist:

Phone:

* Medical Insurance:

* Medical Insurance Policy Number:

* Allergies:

Please list any allergies your child has. If none, list "N/A"

* Medications:

Please list any medications your child is taking and the frequency. If none, list "N/A"

Permission and Medical Release Form:

I/We hereby give permission for my child to be transported by camp transportation and to be supervised by camp staff and volunteers during all camp programs and field trips. My child may participate in all camp activities. I agree to abide by all Camp Chaverim rules, policies and regulations. I acknowledge that photos/video will be taken during camp for promotional purposes.

I/We, the undersigned, parent(s) or guardian(s) of:

* Camper Name:

a minor, do hereby authorize the directors of Camp Chaverim and Congregation Beth Shalom of Napa Valley, or their authorized representatives, as agents for the undersigned, to consent to medical treatment by a state licensed physician, or staff of a licensed hospital to be administered to my child in the event of accident, injury, sickness, etc., until such time as I may be contacted. I also assume the responsibility for the payment of any such treatment. This release shall remain in effect at all times during Camp Chaverim Summer Session 2023.

* Name of Parent/Guardian:

* Date:

Registration Deadline: June 6, 2023

Early registration is recommended to reserve your child’s spot.

Refunds will not be made for campers who withdraw from camp after June 1^st, unless due to serious illness.

* Please check this box to acknowledge that you have read the refund policy above.

Please check this box to acknowledge that you have read the refund policy above.

Tuition & Payment Information:

Camp Chaverim T-shirt and all activities are included in camp tuition.

Note that Camp Chaverim will NOT be held on Tues. July 4.

WEEK #1: June 26-June 30, 9 AM - 3:30 PM-- very few spots left!

Week 1 is very close to full, so all requests to register for Week 1 must now go through the waiting list! If you would like to register your camp for week 1, please indicate that you would like your child to be on the waiting list, and we will verify that there is space before registering your child. You will not be billed unless your child is registered for camp.

Members- $250-- I would like to register my child for Week 1. If there is space, please register my child and bill me for the week; if there is not, please let me know, so that I can decide if I would like my child to be placed on the waitlist!Non-Members- $275-- I would like to register my child for Week 1. If there is space, please register my child and bill me for the week; if there is not, please let me know, so that I can decide if I would like my child to be placed on the waitlist!

WEEK #2: July 3-July 7, 9 AM - 3:30 PM (NO CAMP TUES. JULY 4)

Members - $200Non-Members - $220

Optional Extended Care

We plan to offer extended care each day from 8 am to 5 pm. However, we may not be able to run extended care if we do not have at least three children signed up per day by June 6. If we are not able to run extended care, we will let you know and you will receive a refund for the cost of the extended care.

We will keep the doors of the synagogue closed during extended care. When you arrive, please ring the doorbell so that we can let you in.

Week 1 Extended Care, 8 am to 5 pm-- only register for this if your child has already been officially enrolled in camp!

Week 2 Extended Care, 8 am to 5 pm

If your child attended Camp Chaverim last year, you may have heard about Danielle and Yaara, our fantastic volunteer counselors from Haifa in Israel. Danielle and Yaara won't be back, but we are so excited to announce that we'll have two new amazing teens joining us from Israel this summer!

We are looking for host families for our Israeli teens. As a host family, you would offer one of these teens a home for one week of camp, either the first week or the second week, and you would provide meals for your Israeli teen for that week. There are no other requirements, but our visitors would love to have a chance to explore more of the Bay Area on the weekends, if you have time to take your Israeli on a day trip! If you would be interested in hosting, check the box below to let us know, or email Leah at leah@cbsnapa.org!

We would be interested in learning more about hosting an Israeli teen for a week. Please contact me to tell me more!

Methods of Payment:

Select applicable discounts:
The early bird discount will be applied automatically.

Multi-session discount $15

N/AMulti-session discount

Sibling discount $15

N/ASibling discount

Total Amount Due

Please Sign and click the Submit button below to proceed to the payment page.

Signature (please type full name)