Application - Summer 2025>

Child information
Agreement
Parent information
Emergency & Medical
Terms & Cost
Payment

Child information

First Name

Last Name

Date of Birth

Yeshiva Attending

Apply to Program

Grade Entering

Yeshiva attending other

Current Rebbe

Session Request

T- Shirt Size

First Session: July 1st until July 25th
Second session: July 28th - Aug 20th
Full summer: July 1st - Aug 20th
Early bird ends Sunday night January 19th

Cellphone for text updates

Dynanite is our exciting night program for grades 5th-8th. Dynanite programs occur approximately twice a week. In the beginning of camp, a calendar is distributed with the dates and times of the activities. There is a certain level of maturity that the program necessitates. In order to be considered for the special program, please fill in the information below.

School Rebbe, Principal etc.

Telephone Number

Children Agreements

Parent Agreement

Dynanite is the premiere night program of CMY. Dynanite activities occur twice weekly. Each event includes dinner and an exciting trip or sports/swim activity. In regards to behavior,CMY sets as its policy to always try and make a Kiddush HaShem and to avoid any chillul HaShem chas v'shalom. I have read the camper agreement and maintain that my son understands that his membership as a Dynanite camper is contingent on his appropriate conduct at all times. I recognize that the camp reserves the right to dock my son from any activity or to rescind his membership as Dynanite camper if necessary.

Parent Name:

Parent's Signature

Parent information

Father's Title

Father's Name

Cell #

Mother's Title

Mother's Name

Cell #

Marital Status

Home Phone

Family Shul/Rabbi

Email Address 1

The address that is checked the most often

Email Address 2

Please add this email to the list as well

Address

Primary Address for a Child(ren)

Street

City

State

Zip

Cross Streets

Between what 2 streets are you located

Summer Address

Street

City

State

Zip

Cross Streets

Between what 2 streets are you located

Emergency & Medical Information

Please note: We will try to contact parents before contacting the emergency contact.

First Name

Last Name

Relation

Phone

Child's Doctor's Name

Child's Doctor's Phone

Does Your Child Have Any Allergies?

My Child Is Allergic To

Is Your Child Taking Any Daily Medication?

My Child Takes Daily

I Am Concerned About

Conditions

*ALL CAMP FEES ARE DUE IN FULL BY 06/01/2025. Any special payment arrangements (including scholarships, 3rd party payees, etc..) must be confirmed by camp in writing prior to 05/27/2025. Failure to pay will automatically cancel registration so that your spot can be offered to those on our waiting list.

In order for your registration to be complete a $500 deposit per child (the deposit is included in the total price) must be paid at time of registration. Please see link after form is submitted. If we do not receive your deposit before the early bird ends then your application will be processed as full priced.

Registration Fee ($500) is non refundable. Cancellations after May 1st will result in a cancellation fee of the full camp tuition.

Terms & Conditions:

I, as the parent or guardian and on behalf of my camper(s), understand, acknowledge, and agree as follows:

A Camp Machaneh Yisrael, LLC Medical Form (signed by a physician and a parent or guardian) must be received prior to a camper’s arrival to camp. I am responsible for notifying Camp Machaneh Yisrael LLC of all physical, medical and/or emotional needs of my camper which impairs his ability to participate.
Any and all claims made against the camp and/or its employees, including any monetary disagreements, shall be decided upon only by a Bais Din in accordance with Halacha.
Late arrivals, early departures, or absences will not result in a credit or refund.
We reserve the right to use all pictures taken during the summer for publicity purposes.
We reserve the right to refuse any camper for any reason.
If you do not hear from us within three weeks of sending in your application, please call the camp office to confirm that we received this application.
I understand that all unclaimed “lost and found” items will be assumed hefker one week after camp ends.
I understand that I am monetarily responsible for any damage caused by my camper to the camp property or that of other campers.
In the event of an emergency, Camp Machaneh Yisrael LLC and/or medical staff have authority to act on my behalf according to its best judgment. I understand that I am responsible for the costs relating to treatment of my camper outside of Camp.
I hereby authorize Camp Machaneh Yisrael, LLC to take my child off camp grounds to go on trips organized as part of the camping program. This may include swimming and/or boating sites. In addition, my child may participate in any on or off ground activity organized by camp including but not limited to land sports, aquatic activities, indoor activities, bicycling, hiking, cookouts, etc., I also agree to abide by all rules and regulations as set forth in the camp application, in the information packet and by camp administration.
Cancellation Policy: Registration deposit non-refundable. The balance is refundable in full until May 1. After that, refunds will not be made.
If, for any reason, the government closes camps, full or partial refunds will be available.

I wish to enroll my son(s). I have read this application form and agree to all the conditions listed.

Parent/Guardian Name (Print):

Parent’s Signature

Date

Payment

Payment of your deposit completes your registration. Without your deposit your registration and any discounted rates will not be honored including early bird.
If are not paying your deposit by credit card, we must have your deposit within 7 days or your registration will be invalid.
If paying by check, in order to guarantee your spot we must have post dated checks in hand with the final check being dated no later than Thursday, June 1st, 2025.
Post registration checks must be in hand no later than 7 days after registration to hold your spot.

Please Select Payment Option:

Payment in full

Pay deposit today + send checks for the remaining balance within 7 days (last check dated no later than June 1)

Pay $500 Deposit Today, remaining balance 3 payments- Apr 1, May 1, June 1

Pay deposit by Cash, Check, or QuickPay/Zelle within 7 days + send checks for the remaining balance (last one dated no later than June 1)

A 3% Convenience Fee Will Be Added to All Credit Card Payments

Billing Address

Address*

City*

State*

Zipcode*

Card Details

Name On Card*

Card Number*

Expiry Date*

CVV*

Amount

Text

Machaneh Yisrael Application 2025

Terms & Conditions:

Billing Address

Card Details