Camp Registration End of Summer Camp 2019- Daily trips, fun, friendship and Jewish activities!Monday, Aug 26- Wednesday, Aug 28 10:00 AM- 3:00 PM $45 dollars a day (includes snacks) Monday- Cold Spring Harbor Fish Hatchery & Aquarium and Music Jam Tuesday- Children’s Museum of the Arts and Park Wednesday- @Play Amusements (Indoor rides, arcades and bounce) Drop off and pick up at Chabad (74 Maple Ave. Cedarhurst). Limited space available. Child's Name* First Last Primary Email for all camp notifications* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Child's Birthdate* Home PhoneFather's CellMother's CellDoes your child have any allergies or special diet? (if yes, please be very specific, and detailed)*Does your child take any medications during the hours of 10:00-3:00?*Is your child toilet trained?*YesNoList any activities you would not like your child to participate in?Anything else you would like us to know about your child, comments, and suggestions?* I hereby give permission to the Friendship Circle to transport my child during camp. I hereby give permission to the Friendship Circle to use my child’s photo online or print. Emergency Contacts(IN CASE A PARENT CAN NOT BE REACHED)Emergency Contact* First Last Emergency Contact I Phone*Emergency Contact II* First Last Emergency Contact II Phone*How many days will your child be attending camp?*1 day2 days3 days$45/dayWhich days will your child will be attending?** Monday- Aug 26 Tuesday- Aug 27 Wednesday- Aug 28 Total $0.00 Payment Method*Credit CardCheckOtherCredit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name ImportantPlease make sure your child has a nut free lunch, each day, and is wearing sunscreen. All belongings and lunch bags should be labeled. If your child requires medication, a car seat, or a change of clothes, please be sure to bring it. We ask that in case your child is not able to make it or you are running late, please text Batsheva at 917-592-3338, so the bus and volunteer don’t wait. Looking forward to a safe and fun camp experience.