Parent/Guardian

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Last Name

Email

Phone

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I would like to add a second adult.

Parent/Guardian 2

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How many children do you have?

Child 1

First Name

Last Name

Grade as of Fall 2022

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Child 2

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Grade as of Fall 2022

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Child 3

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Last Name

Grade as of Fall 2022

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Child 4

Please provide information about any additional children here:

I am interested in learning more about:

URJ Crane Lake Camp (West Stockbridge, MA)URJ Eisner Camp (Great Barrington, MA)URJ 6 Points Sci-Tech Academy East (Byfield, MA)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?

Share a little more about your family! (Who referred you, are you an alum, or anything else you want us to know about your children.)

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