2014 Camp Registration

Please fill out one individual form per Camper.

Registering for:*
Select all camps being registered for on this form.

Camper Information


Parent/Guardian Information

Parent/Guardian 1

Parent/Guardian 2

Parent's marital status:
Child lives with:
I would be interested in hosting an Israeli staff member.

Membership Information

Continuous family membership must be current from enrollment through the camp season to qualify for member rate.

Emergency Contact Information

Who should we contact in an emergency in the event that you are unreachable?

Contact 1

Contact 2


Health Insurance Information

Health History

Please complete the following health-related questions and attach a copy of your child's "Health Assessment" or "School Form" (with immunization records) prepared by a physician.
To grant permission to administer ANY medications (including over the counter) the enclosed "Child Health Form for Physician" must be completed as well.

Does your child have or had any of the following:

Confidential Participant Information

Our goal is to ensure a wonderful and safe experience for your child. All information provided will be held in the strictest of confidence and used to inform and sensitize the staff to the specific needs of your child.

Camp Sisol - Entering Grades K-6

KidStage - Entering Grades 3-6

KidSport - Entering Grades 3-6

Specialty Camps - Entering Grades 3-6

Teen Travel - Entering Grades 7-9
(Choose your session. Each session is 2 weeks.)

Counselor in Training - Entering Gr. 10 (Choose sessions. Each session is 4 weeks.)

Before and After Care

Tuition Guide

Grades K-2Grades 3-6Chalutzim (Teen Travel)CITHobby CampBefore Camp CareAfter Camp Care
Member/Non Member Member/Non Member Member/Non Member Member/Non Member Member/Non Member Member/Non Member Member/Non Member
1 Week 290/340 340/395 920/1035 280/320 FREE 14/15 per day
2 Weeks 280/335
per week
per week
65/70 per week
3 weeks 275/330
per week
per week
4 weeks 260/315
per week
per week
5 weeks 255/310
per week
per week
6 weeks 250/305
per week
per week
7 weeks 245/295
per week
per week
8 weeks 245/295
per week
per week

Bus Arrangements

Bus schedules are subject to change. Before Camp Care is available at no additional charge. (7am at the JCC)

If the bus is more than 15 minutes late for morning pick-up or if you miss the bus, please call camp and bring your child to Markus Park. Please go to the JCC to pick-up your child if the bus is more than 15 minutes late in the afternoon or if you miss the bus.

If a parent or authorized adult is not at the bus stop to pick a camper up when the bus arrives in the afternoon, the bus will wait 1-2 minutes after which the camper will be brought back to the JCC. Parents will be charged for one day of After Camp Care.

Swim Lesson Information

Payment Information

Registration is not complete until payment method has been provided, the deposit paid, and Health and Immunization Forms have been turned in.

Please select method of deposit and balance payment option below.
*Non-refundable $20/week deposit is due upon registration for all Camp Sisol Programs.

Sibling discount: $15/week
For siblings attending another JCC Camp, the lower cost camp's discount will apply.

Applications for financial assistance are granted on a need and first come-first-served basis.

Parent/Guardian Consent and Agreement

The JCC agrees to enroll your child in its camp programs based on the choices selected herein (pending availability), subject to the terms and conditions as set forth in the remainder of this agreement. We/I expressly understand and agree to the following terms and conditions (please initial next to each section):

Payment and Registration

  1. The information provided on this form is correct and complete to the best of my knowledge.
  2. We/I agree to pay all camper fees in accordance with the camper's registration. There is no fee reduction or reimbursement for absence during a session (exceptions may be made for medical reasons with a note from your child's pediatrician). In the event that we/I shall fail to pay the fees for the camp program as agreed, the JCC shall immediately cancel the child's enrollment in the JCC camp program, unless otherwise arranged with the JCC. It is expressly understood that this agreement is a binding contract and will be enforced.
  3. No refund will be given for children sent home due to disciplinary or adjustment problems. Every effort will be made to accommodate the individual needs of the child in his/her adjustment to the JCC camp programs. The JCC reserves the right to request withdrawal of said child where he/she is unable to adjust to the program. Any request for withdrawal shall be made to us/me and only after every attempt has been made to resolve the problem.
  4. We/I understand and agree that if the JCC must use legal proceedings to collect any unpaid fees pursuant to this contract, we/I will be responsible for legal costs and expenses incurred by the JCC related to such legal proceedings.
  5. We/I hereby agree that we/I will abide by camp rules and policies. We/I further agree to abide by any other reasonable requirements or policy rulings set forth by the director in the day-to-day operation of the camp program.
  6. We/I understand that we/I are responsible for providing written notice to the camp office informing of any and all changes to camper registration. We require written notice of session cancellation 14 days in advance of the session beginning for refunds. You will be refunded the session tuition less the initial deposits. Cancellations received less than 14 days in advance will result in a credit that may be used towards another 2014 session pending availability.

Attendance and Transportation

  1. We/I will notify camp if my child will not attend camp, arrive late or be picked up early.
  2. My child has permission to ride the bus to and/or from camp.
  3. In the event that we/I are late for the afternoon bus, the child will be taken to After Camp Care at the JCC. The usual After Camp Care fee will be charged.
  4. Late pick-up from After Camp Care (after 6 pm) will result in an automatic charge of $10 for each 15 minutes after 6pm.

Activities and Permissions

  1. My child has my permission to engage in all activities except as noted herein.
  2. My child has my permission to:
    • Go swimming with the group (I will provide a bathing suit and towel)
    • Have photographs and/or videos taken and used for publicity for the JCC
    • Have his/her name published on a class list which is to be posted in the private, parent section of the camp website.
  3. I understand that I must explicitly grant or decline permission for each late night, overnight, field trip and excursion. Dates and electronic RSVPs (permission slips) are available at jccrochester.org/camp-sisol/parent-information.

Medical and Emergencies

  1. I agree to provide sun screen for my child and hereby grant permission to staff to assist my child in its application.
  2. I hereby give permission to the medical personnel selected by the director of the program to provide routine health care and to administer as needed over-the-counter medications as indicated on the separate JCC health form and authorized by his/her physician. I hereby waive all claims which might arise from the administration of this medication.
  3. In case of emergency and in the event that I or person(s) I have designated cannot be reached immediately, I authorize the Camp Director or his/her designated staff to act on my behalf according to their best judgment, to administer first aid and/or medications and to provide or arrange necessary related transportation for my child. I give permission to the physician selected by the program to order x-rays and/ or routine tests, to secure and administer treatment, including hospitalization, anesthesia or surgery for my child and to release any records necessary for insurance purposes. I authorize the release of any information provided herein that the hospital or physician in their sole discretion may deem proper. All health-related information may be reproduced. I further understand that I am responsible for all medical costs incurred.
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