Congregation of Temple Israel

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Family Camp Weekend
April 17-19, 2020

Family Camp is subsidized by grants and generous donations.
If you need additional financial support, please contact Ben Mazur, bmazur@templeisraelomaha.com, before registering

Registration

Qty

Description

Amount

Total

Family Registration

$350.00

A 3% courtesy fee will be added to your transaction.

Parent Information

Parent #1 Name: *

Parent #1 Phone: *

Parent #1 Email: *

Parent #1 T-shirt Size: *

(unisex)

Children Information

Child #1 Name: *

Age: *

T-Shirt Size: *

(sizes are in youth)

Do you have any allergy or mobility concerns?

Will you give permission to Temple Israel to use photographs taken at Family Camp in our print or digital publications?

Permission to use photos taken at camp: *

Payer Information

First Name: *

Last Name: *

Billing Address: *

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Email: *

A receipt will be e-mailed to this address.

Telephone:

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *