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

Grade as of Fall 2021

Gender

Child 2

First Name

Last Name

Grade as of Fall 2021

Gender

Child 3

First Name

Last Name

Grade as of Fall 2021

Gender

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.)

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