Apply Online

Mother's Name *

First

Last

Father's Name *

First

Last

Mother's Cell # *

Father's Cell # *

Mother's Email *

Father's Email *

Emergency Contact *

First

Last

Emergency Contact Tel # *

Doctor's Name *

Doctor's Phone Number *

Summer Address/ Name of Colony (include Unit #) *

Summer Home Phone # *

Please fill out ALL fields for each child applying.

Price includes nit checking and bathing cap.

Payment Information

Please email tribecadaycampoffice@gmail.com if you do not receive a confirmation text/email within 2 days of applying.

Your credit card will be processed fully once we have received your application. If you would like to set up a payment plan or to pay by check, please email us immediately. If we do not received payment or hear from you regarding a payment plan, we will not process your application and your child/ren will not be enrolled in camp.

If you would like to pay by check, please mail a check payable to Congregation Anshei Tribeca
to our office at: N. Kuriansky, 1195 East 10th Street, Brooklyn, NY 11230.

Your child is considered registered once payment clears and all medical forms are received.

RELEASE OF LIABILITY

I release TRIBECA DAY CAMP, all Tribeca staff, its principals, board, founders and camp committees, and their families, from any liability of any sort. I do not hold TRIBECA DAY CAMP responsible for any injuries sustained while my children are in camp or on any camp trips.

TRIP PERMISSION

I allow my children to attend all trips run by TRIBECA DAY CAMP.

MEDICAL & IMMUNIZATION ACKNOWLEDGEMENT

Please be aware that your child's placement in Tribeca Day Camp is not confirmed until ALL necessary forms have been received. Any penalties issued by the NYS Board of Health will be charged to the families with delinquent accounts.

APPLICATION

Family Information

Please fill out ALL fields for each child applying.

Child 1

Child 2

Child 3

Child 4

Payment Information

RELEASE OF LIABILITY

TRIP PERMISSION

MEDICAL & IMMUNIZATION ACKNOWLEDGEMENT