Camp Mesorah - Camp Mesorah Application

2011 Summer Prices And Dates

(dates subject to change)

	Grade	Full Season Jun 27 - Aug 18	First Session Jun 27 - Jul 25	Second Session Jul 26 - Aug 18
Regular Girl/Boy Camper	3-8	$6400.00	$4200.00	$3600.00
Teen Girl/Boy Camper	9-10	$7300.00	$4200.00	$4500.00 (includes 3 day/2 night trip)
CIT-Camper Boy/Girl	11	$3800.00
Kollel		$1750.00	$250.00 per week

_________

Mini-Mesorah	Jun 27 - Jul 11	$1800.00 (includes $50 in canteen money, 2 cases of water, and all tips)
Mesorah Experience	Jul 26 - Jul 28	STILL FREE! Limited space available!
Sportstar Academy	Aug 21 - Aug 25	$400 Includes Transportation

To apply online please fill out the form below.

Online Application for 2011

Please submit this application with a deposit of $1000 (Full Season); or $500 (Half Season) in order for your application to be processed. After January 1st, fees are non-refundable. No allowance will be made for late arrivals, early departures or late cancellations. Camp fees include laundry service, trips, Mesorah T-shirt and transportation from the NYC Metropolitan area. Pay online here.
Camper Information
Name * First Last
Gender * Male Female
Social Security # (Please leave out the dashes)
Phone * - (###) - ### ####
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Camper Email *
Date of Birth * / MM / DD YYYY
Grade Entering Sep 2011 *
Camp attended last year *
School Information/Reference
School Enrolled: *
School Phone * - (###) - ### ####
Teacher Reference * First Last
Parent Information
Salutation *
Mothers name * First Last
Day Phone * - (###) - ### ####
Night Phone * - (###) - ### ####
Cell Phone * - (###) - ### ####
Mothers Email *
Fathers Name First Last
Day Phone - (###) - ### ####
Night Phone - (###) - ### ####
Cell Phone - (###) - ### ####
Fathers Email
How did you find us?
Medical Information
Dr. Name * First Last
Phone # * - (###) - ### ####
Session Attending
MAIN CAMPUS GIRLS AND BOYS(Entering Grades 3-8) FULL SUMMER - $6400.00 FIRST SESSION - $4200.00 SECOND SESSION - $3600.00 5 fun days (Jul 28 - Aug 1) - FREE
TEEN CAMPER GIRLS AND BOYS(Entering Grades 9-10) FULL SUMMER - $7300.00 FIRST SESSION - $4200.00 SECOND SESSION - $4500.00
MINI-MESORAH (Entering Grades 3-5) First Two Weeks (June 27 - July 11) - $1800.00
MESORAH EXPERIENCE (Entering Grades 3-8) 5 fun days (Jul 26 - Jul 28) - FREE
CIT/CAMPER (Entering grade 11) Full summer - $3800.00
Kollel $250 Per week or $1750 for the Full Summer

SUMMER DATES

FULL SUMMER Jun 27 - Aug 18

FIRST SESSION Jun 27 - Jul 25

SECOND SESSION Jul 26 - Aug 18

MINI-MESORAH Jun 27 - Jul 11

MESORAH EXPERIENCE Jul 26 - Jul 28

Please list bunk requests (up to 3)and add any comments here.

FULL SUMMER		Jun 27 - Aug 18
FIRST SESSION		Jun 27 - Jul 25
SECOND SESSION		Jul 26 - Aug 18
MINI-MESORAH		Jun 27 - Jul 11
MESORAH EXPERIENCE		Jul 26 - Jul 28

Camper Information

School Information/Reference

Parent Information

Medical Information

Session Attending

SUMMER DATES FULL SUMMER Jun 27 - Aug 18 FIRST SESSION Jun 27 - Jul 25 SECOND SESSION Jul 26 - Aug 18 MINI-MESORAH Jun 27 - Jul 11 MESORAH EXPERIENCE Jul 26 - Jul 28

SUMMER DATES

FULL SUMMER Jun 27 - Aug 18

FIRST SESSION Jun 27 - Jul 25

SECOND SESSION Jul 26 - Aug 18

MINI-MESORAH Jun 27 - Jul 11

MESORAH EXPERIENCE Jul 26 - Jul 28