CAMPER INFORMATION

Camper's Name:*
Sex:*
Camper's Email:*
Home Fax:*
Camper's Address:*
City:*
 
State:* Zip:* Country:
Home Phone:*
Date of Birth:*
Mo: Day: Year:
School Name:
 
Grade in School as of Sep. 2005:*
Grouping Request:

PARENT INFORMATION

Father's Name:
Father's E-Mail:
 
Home Phone:
 
Work Phone:
 
Cell Phone:
Mother's Name:
Mother's E-Mail:
 
Home Phone:
 
Work Phone:
 
Cell Phone:
Address:
City:
 
State: Zip: Country:

IN CASE OF EMERGENCY

Name:
Relationship:
 
Home Phone:
 
Work:
Address:
City:
 
State: Zip:   Country:

HOW DID YOU HEAR ABOUT JULIAN KRINSKY CAMPS AND PROGRAMS?

Previously Attended JKCP
Which Camp:
Number of Years:
From Another Camper
Name:
Advertisement
Publication:
Camp Fair
Name:
Camp Referral Agency
Name:
Teacher/Coach/Pro
Name:
Other

FOR COMPLETION BY PARENT/GUARDIAN

I give my permission for my son/daughter to participate in the 2005 Julian Krinsky Yesh Shabbat program. I agree that my son/daughter will abide by the camp rules and realize any breach of these rules may result in his/her immediate dismissal without refund of any fees.

I authorize Julian Krinsky Yesh Shabbat, or its authorized representatives, to take whatever actions it may consider warranted under the circumstances regarding my child's health and safety. I fully release Julian Krinsky Camps & Programs and its authorized representatives from any liability for such circumstances or actions as may be taken in connection therewith.

I authorize Julian Krinsky Camps & Programs, or its authorized representatives, at its discretion, to place my child, at my expense and without further consent, in a hospital for medical services and treatment, or if no hospital is readily available, to place my child in the hands of a licensed doctor for treatment. Camp may elect to access my family health/accident policy.


Julian Krinsky Camps & Programs retains the right to use photographs of this camper for advertising purposes.

I have carefully read the above information and agree to the conditions stated.

For consent, please check box
Please check here if any medical, physical or other conditions may limit your child's ability to fully participate in any activity.

PLEASE CHECK SESSIONS DESIRED:

OVERNIGHT

DAY
Session 1: June 23 - July 6 Session 1: June 24 - uly 6
Session 2: July 7 - July 27 Session 2: July 7 - July 27 
Session 3: July 28 - August 11 Session 3: July 28 - August 11

Optional Start Dates

 
Session 1: June 29 - July 6  
Session 2: July 21 - July 27  
Session 3: August 3 - August 11  


Please sign up for the program(s) you wish to participate in. Choose one of the following programs for each week you will attend: tennis, golf, basketball, soccer, and creative & fine arts. You may choose the same program, or a different program, for each week of the session, but all campers must enroll for a full 2- or 3-week session.

Session 1 Session 2 Session 3
Week 1 Week 1 Week 1
Week 2 Week 2 Week 2
  Week 3  

WEEKLY PROGRAM PRICING:

Overnight Camp Tuition

Session 1: $1,890

Session 2: $3,200
Session 3: $1,990


Optional Start Date Prices

Session 1: $1,080
Session 2: $945
Session 3: $1,215


Price includes tuition, private or semi-private room with a fan and refrigerator, and all meals. Price does not include off-campus weekday trips

Please note: There is an extra charge of $140/week for all off-campus trips, which includes meals, entertainment and recreation admission fees.

Day Camp Tuition

Session 1: $720

Session 2: $1,200
Session 3: $800

Price includes tuition and lunch

OPTIONAL SERVICES :

Afternoon tennis
(for Enrichment Campers)
$75/week
Linen service:
$12/week
Laundry service:
Charged by the pound
Transportation to and from Philadelphia International Airport:
$50 round trip, $30 one way
Van shuttle to/from New York City, Tarrytown or Newark Airport:
$60 one way, $100 round trip
Overseas camper surcharge:
$150 per camper
(includes local airport pickup and drop off, laundry and linen services)

PAYMENT DETAILS:

A $750 deposit plus a $50 non-refundable application fee for overnight campuers or a $350 deposit plus a $50 non-refundable application fee for day campers must be sent under seperate cover within two weeks of submitting application. Full payment is due April 1, 2005 or enrollment may be subject to cancellation. Reservations are made in order of receipt. We will notify you if preferred weeks are not available.

Refund/Cancellation Policy: Notification of withdrawal must be made in writing to the camp. Refunds will be made as follows:

Withdrawal Date:       By May 1st        May 2nd and later
Amount of Refund:
  All but $300   No refund without cancellation insurance*

*Julian Krinsky Camps & Programs offers cancellation insurance that provides a refund of all but $300 of your total payment. The price of insurance is 5% of your tuition. There will be no refund of tuition after May 1st if cancellation insurance is not paid in full by that date.

Even if cancellation insurance is paid for, there will be no refund for a camper who is asked to leave the camp for the use of drugs or alcohol, non-notification of a serious medical condition, or whose conduct is detrimental to the camp. These decisions are at the sole discretion of Julian Krinsky Camps and Programs. No refund will be made for late arrival, early departure, or withdrawal due to family vacation.

Please send payment with check(s) payable to:

Julian Krinsky Camps & Programs
610 S. Henderson Rd.
King of Prussia, PA 19406 USA

Phone: (610)265-9401 or 1(866) TRY-JKCP
Fax: (610) 265-3678

Payment of Fees for Overseas Campers:

1. Money should be transferred to Wachovia Bank, Philadelphia, PA 19101.
2. ABA (routing) # 031201467
3. Swift: PNBPUS33
4. Deposit payment to: JKST, Inc. A/CT #2000013367204
5. Reference: Camper's Name / Yaish Program

SUBMIT APPLICATION:

Thank you for submitting your application. We look forward to seeing you soon.

 

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