Camp B’nai Ruach Add-on Registration – Congregation B'nai Israel

Please fill out the below form only if you have already registered for Camp B’nai Ruach and would like to add additional weeks of camp for your child(ren).

Camp B’nai Ruach Date Add-on Form

"*" indicates required fields

Number of children you are registering:*

One

Two

Three

Four

Camper 1 – Name*

First Last

Camper 2 – Name*

First Last

Camper 3 – Name*

First Last

Camper 4 – Name*

First Last

Is there anything additional you would like to mention about your children to ensure your camper has a wonderful time at camp?

I want to:

Add extended care to my camper’s registration

Are you a member of Congregation B'nai Israel?*

Do you want to add Extended Care to your child(ren)'s camp day?*

CAMP HOURS & EXTENDED CARE
Camp hours are 9:00 am – 4:00 pm daily. Extended care is offered from 8:00 am – 9:00 am and 4:00 pm – 6:00 pm. EC weekly rates include morning and afternoon care and can be added to camp tuition discounted at $130 a week. Daily rate is $20 per hour/per child. If your child arrives prior to 9 am or is picked up after 4 pm, you will be billed for extended hours.

Camp Pricing Summer 2023
Camp Weeks 1,3,4,5 – CBI Member $350/Non-member $375
Camp Week 2 – CBI Member $300/Non-member $320
Extended care $130/week/camper

Camp weeks or extended care dates you'd like to add:*

Camp Week 1 (6/26-6/30)

Camp Week 2 (7/3-7/7)

Camp Week 3 (7/10-7/14)

Camp Week 4 (7/17-7/21)

Camp Week 5(7/24-7/28)

Extended Care Week 1 (Add # of campers)

Price: $130.00

Extended Care Week 2 (Add # of campers)

Price: $104.00

Extended Care Week 3 (Add # of campers)

Price: $130.00

Extended Care Week 4 (Add # of campers)

Price: $130.00

Extended Care Week 5 (Add # of campers)

Price: $130.00

Week 1 – Member – No EC (Add # of campers attending this week)

Price: $350.00

Week 1 – Member – EC (Add # of campers attending this week)

Price: $480.00

Week 1 – Non Member – No EC (Add # of campers attending this week)

Price: $375.00

Week 1 – Non Member – EC (Add # of campers attending this week)

Price: $505.00

Name of Campers Attending Week 1

Week 2 – Member – No EC (Add # of campers attending this week)

Price: $300.00

Week 2 – Member – EC (Add # of campers attending this week)

Price: $430.00

Week 2 – Non Member – No EC (Add # of campers attending this week)

Price: $320.00

Week 2 – Non Member – EC (Add # of campers attending this week)

Price: $450.00

Name of Campers Attending Week 2

Week 3 – Member – No EC (Add # of campers attending this week)

Price: $350.00

Week 3 – Member – EC (Add # of campers attending this week)

Price: $480.00

Week 3 – Non Member – No EC (Add # of campers attending this week)

Price: $375.00

Week 3 – Non Member – EC (Add # of campers attending this week)

Price: $505.00

Name of Campers Attending Week 3

Week 4 – Member – No EC (Add # of campers attending this week)

Price: $350.00

Week 4 – Member – EC (Add # of campers attending this week)

Price: $480.00

Week 4 – Non Member – No EC (Add # of campers attending this week)

Price: $375.00

Week 4 – Non Member – EC (Add # of campers attending this week)

Price: $505.00

Name of Campers Attending Week 4

Week 5 – Member – No EC (Add # of campers attending this week)

Price: $350.00

Week 5 – Member – EC (Add # of campers attending this week)

Price: $480.00

Week 5 – Non Member – No EC (Add # of campers attending this week)

Price: $375.00

Week 5 – Non Member – EC (Add # of campers attending this week)

Price: $505.00

Name of Campers Attending Week 5

Parent Signature*

Date*

Payment Information

Payment Method*

I will send a check to the CBI office

Credit Card (Visa or MasterCard)

No exceptions will be made. No refunds after June 22, 2023. Add-ons welcome if there is space!
Questions? Please contact Camp Director – Sheri Galante (310)918-3702 camp@cbi18.org

CHECK PAYMENT
Please make checks payable to: CBI Camp B’nai Ruach
Mail payments to: 2111 Bryan Avenue, Tustin, CA 92782

Total

Parent Email

Parent Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name