Preschool Camp 2025

Each registration requires full payment by June 1, 2025.
If registering multiple children, complete one registration form for each child.

Summer Camp is available for children ages 18 months through age 5 (as of June 1, 2025).

All camp tuition must be paid in full by June 1, 2025. You may pay in full or installments by credit card or EFT. If you would prefer to send a check, select bill to your account and send a $250.00 non-refundable deposit within 7 days of registering.

You can pay by logging into your ShulCloud account here: https://www.etzhayim.net/ and then clicking on the member portal at the top.

Please contact preschool@etzhayim.net with any questions.

Student Information

* Child's - First Name:

* Child's - Last Name:

* Child's - Birthday:

*Must be 18 months by June 1st

* Child's - Age on 06/01/2025

Parent Information

* Parent 1 - First Name:

* Parent 1 - Last Name:

* Parent 1 - Email:

* Parent 1 - Cell phone:

* Home Address:

* City:

* Zip Code:

* How did you learn about our Summer Camp?

Parent 2 - First Name:

Parent 2 - Last Name:

Parent 2 - Email:

Parent 2 - Cell phone:

Address if different from child:

Sessions

In the session boxes below, please select the timed sessions that you wish your child to attend for that session. For example, if you would like your child to attend from 8:00-5:30, you should select Full day, early drop off and late pick up. If you do not wish for your child to attend any given session, leave it blank.

Session 1: June 16-20 (no camp on Thursday, June 19th)

Session 2: June 23-27

Session 3: June 30-July 3 (no camp on Friday, July 4th)

Full Day (8:30-5:00) - $360.00Core morning (9:30-12:30) - $216.00Core morning through lunch 9:30-2:00 - $264.00Morning Drop In (8:30-9:30) - $56.00Early Drop off (8:00-8:30) -$40.00Late pick up (5:00-5:30) - $40.00

Full Day (8:30-5:00) - $450.00Core morning (9:30-12:30) - $270.00Core morning through lunch (9:30-2:00) - $330.00Morning Drop in (8:30-9:30) - $70.00Early drop off (8:00-8:30) - $50.00Late pick up (5:00-5:30) - $50.00

Full Day (8:30-5:00) - $360.00Core morning (9:30-12:30) - $216.00Core mornng through lunch (9:30-2:00) - $264.00Morning drop off (8:30-9:30) - $56.00Early drop off (8:00-8:30) - $40.00Late pick up (5:00-5:30) - $40.00

Session 4: July 7-11

Session 5: July 14-18

Session 6: July 21-25

Full day - (8:30-5:00) - $450.00Core morning (9:30-12:30) - $270.00Core morning through lunch (9:30-2:00) - $330.00Morning Drop in (8:30-9:30) - $70.00Early drop off (8:00-8:30) - $50.00Late pick up (5:00-5:30) - $50.00

Session 7: July 28-August 1

Session 8: August 4-8

Session 9: August 11-15

Emergency Contacts

Please list two emergency contacts that we can call in the event that the child's parent(s) can not be reached.

* Emergency Contact Name 1:

* Emergency Contact Phone 1:

* Relationship to child

* Allowed to pick up child?

YesNo

* Emergency Contact Name 2:

* Emergency Contact Phone 2:

* Relationship to child

* Allowed to pick up child?

YesNo

WAIVER:

* My child has permission to participate in CEH's Preschool programs. In consideration of my child's acceptance as a student, I hereby waive any and all claims against CEH, its agents and employees that may arise out of any injury, loss, or damage suffered by my child during any Preschool activity. I authorize the Director of the Preschool or his/her designee to obtain emergency medical care for my child in the event such care is indicated. I give permission for my child to receive emergency medical care by any nurse, doctor, paramedic, or member of a medical staff of a hospital licensed by the State of Virginia. I understand that every effort will be made to notify a parent/guardian prior to treatment. I certify that my child is in good physical health and has permission to participate in all activities that are part of the Preschool program. Please enter your name to confirm that you have read, understand, and agree to these permissions.

My child has permission to participate in CEH's Preschool programs. In consideration of my child's acceptance as a student, I hereby waive any and all claims against CEH, its agents and employees that may arise out of any injury, loss, or damage suffered by my child during any Preschool activity. I authorize the Director of the Preschool or his/her designee to obtain emergency medical care for my child in the event such care is indicated. I give permission for my child to receive emergency medical care by any nurse, doctor, paramedic, or member of a medical staff of a hospital licensed by the State of Virginia. I understand that every effort will be made to notify a parent/guardian prior to treatment. I certify that my child is in good physical health and has permission to participate in all activities that are part of the Preschool program. Please enter your name to confirm that you have read, understand, and agree to these permissions.

* My electronic signature below represents the commitment to paying the full tuition as indicated by my program selection(s) on this application.

My electronic signature below represents the commitment to paying the full tuition as indicated by my program selection(s) on this application.

* PARENT NAME:

2025 Etz Hayim Preschool Summer Camp

WAIVER: