Who?
What?
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When?
Application
Photo Gallery 2007
Photo Gallery 2008
About Us
Directions
Contact Us
Staff
732-415-7444
The summer experience of a lifetime!
Application
Personal Information
First Name:
Last Name:
Date of birth:
Phone:
Cell Phone:
SSN:
Address:
City:
State:
Zip:
Email:
Father's Name:
Mother's
Maiden Name:
In Emergency Contact:
Contact Phone Number:
Referred to this camp by:
Phone Number:
Other friends attending: (Is there a friend you’d like to be placed with?):
Schooling History
Year graduated from high school:
Please list the school(s) you’ve attended & years attended:
Are you currently employed?
(If yes where?)
Camp History
Camp names and summers attended:
Medical History
All information will be kept strictly confidential
Please list any allergies you may have and how we can make sure you are as comfortable as possible in camp:
List any medications presently taking:
Reason for taking these medications:
Please list any history of anxiety, depression, and eating disorders:
Religious Background
I was:
Born Jewish
Converted
Not Jewish
Born Jewish:
Mom
Dad
Grandparents
Not Jewish:
Mom
Dad
Grandparents
Converted:
Mom
Dad
Grandparents
Maternal Grandmother’s maiden name:
Religious affiliation:
Orthodox
Modern Orthodox
Conservative
Reform
Traditional
Non-Affiliated
What country is your family from originally?
What year did your family move here?
References
Please list two non-related Jewish references. These can be Rabbis or teachers:
Reference #1:
Phone:
Reference #2:
Phone:
Women's Sessions
Full Session:
June 27 - July 29
Session 1:
June 27 - July 13
Session 2:
July 13 - July 29
Payment
A deposit of $100 is required at the time of registration. Money will be refunded if you are not accepted. For financial assistance please download our scholarship application.
Credit Card #:
Exp.:
Camp Activities
Our new location is the ideal place to vacation, learn and have lots of fun! Please rate these activities according to how much you enjoy them on a scale of 1 to 10 (1 not the best 10 super!)
Swimming (Indoor/Outdoor)
1
2
3
4
5
6
7
8
9
10
Paddle Boating
1
2
3
4
5
6
7
8
9
10
Ropes Course
1
2
3
4
5
6
7
8
9
10
Over the Lake Zip Line
1
2
3
4
5
6
7
8
9
10
Archery
1
2
3
4
5
6
7
8
9
10
Handball
1
2
3
4
5
6
7
8
9
10
Paddleball
1
2
3
4
5
6
7
8
9
10
Tennis
1
2
3
4
5
6
7
8
9
10
Basketball
1
2
3
4
5
6
7
8
9
10
Horseback Riding
1
2
3
4
5
6
7
8
9
10
Shuffle Board
1
2
3
4
5
6
7
8
9
10
ATV
1
2
3
4
5
6
7
8
9
10
Jewish Topics
1
2
3
4
5
6
7
8
9
10
Aerobics
1
2
3
4
5
6
7
8
9
10
Hiking
1
2
3
4
5
6
7
8
9
10
Baking
1
2
3
4
5
6
7
8
9
10
Mini Golf
1
2
3
4
5
6
7
8
9
10
Volley Ball
1
2
3
4
5
6
7
8
9
10
Baseball
1
2
3
4
5
6
7
8
9
10
Guitar Lessons
1
2
3
4
5
6
7
8
9
10
Bumper Boating
1
2
3
4
5
6
7
8
9
10
Bike Trails
1
2
3
4
5
6
7
8
9
10
Our Program
We are in the process of designing a dynamic and thought provoking learning program for Discover U. Please list any Jewish topics that you would like to learn more about so we can tailor-design our program around you!
How did you hear about our program and why would you like to come?
Do you have any friends or relatives who may be interested in DiscoverU program? Please list their names and phone numbers.
Please desribe yourself :
Campgrounds
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What?
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Where?
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When?
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About Us
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Copywrite 2007 You Discover.
