Camp Shamayim Registration Form 2017

  • $150 per session
  • $10 sibling discount
  • Payments are requested every Friday
  • Please make checks payable to Camp Shamayim

I would like to enroll my Daughter(s), Son(s):

(If applying for more than one child, you may use the same form and write the information in the same order for each field .)


Please check off which sessions you will be attending.


Contact Information


Medical Information