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Parent/Guardian

First Name

Last Name

Email

Phone

Zip / Postal

I would like to add a second adult.

Parent/Guardian 2

First Name

Last Name

Email

Phone

How many children do you have?

Child 1

First Name

Last Name

2024-2025 Grade

Gender

Child 2

First Name

Last Name

2024-2025 Grade

Gender

Child 3

First Name

Last Name

2024-2025 Grade

Gender

Children 4+

Please enter information for any additional children here.

I am interested in learning more about:

URJ Camp Coleman (Atlanta, GA)URJ 6 Points Creative Arts Academy (West Chester, PA)URJ 6 Points Sports Academy (Asheville, NC)

If you are a member of a Reform congregation, which one?

How did you hear about us?

Additional Comments

By submitting this form, you agree to receive information from URJ camps about summer programming.

Union for Reform Judaism | Religious Action Center | ReformJudaism.org | Youth & Teen Programs

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