Skip to main content
Upcoming Events
Study
Applied Jewish Mysticism
Jewish Learning Institute
Online Resources
Kids & Teens
Children's Events
JAMS After-School
JAMS Summer Camp
Teen Club
Nashim
About Nashim
Ladies Night Out
Torah & Tea
About
Who We Are
The Team
What is Chabad
Contact Us
Shareholders
Donate
2026 JAMS Jewish Summer Camp
Registration Form
Please note, there is a non-refundable $30 application fee.
Parent 1
First Name
*
Last Name
*
Cell Phone
*
Home Phone
Work Phone
Email
*
Occupation
*
Street Address
*
Address Line 2
City
*
Postal Code
*
State/Province
*
Is parent 1 Jewish?
*
Yes
No
Are there any conversions in parent 1 family Background?
*
Yes
No
please explain more:
*
Is parent 1 a single parent?
*
Yes
No
Will other parent ever be responsible for drop-off or pickup?
*
Yes
No
Parent 2
First Name
*
Last Name
*
Cell Phone
*
Home Phone
Work Phone
Email
*
Occupation
*
Share address of
Same address as Parent 1
Street Address
*
Address Line 2
City
*
Postal Code
*
State/Province
*
Is parent 2 Jewish?
*
Yes
No
Are there any conversions in parent 2 family Background?
*
Yes
No
please explain more:
*
Child 1
First Name
*
Last Name
*
Gender
*
- Select -
Female
Male
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
PLEASE SELECT The WEEKS YOU would like TO REGISTER FOR
*
Week 1 (June 15 - June 19)
Week 2 (June 22 - June 26)
Name of Current School
*
Grade
*
- Select -
TK
K
1
2
3
4
5
6
swimming abilities
*
Beginner (needs floaties)
Intermediate
Advanced (swims in DEEP-END unassisted)
biking abilities
*
Beginner (learning to bike with 2 wheels)
Intermediate
Advanced
favorite activities and interests
*
any allergies or medical conditions?
*
Yes
No
please specify
*
What are you hoping your family will gain from the JAMS Jewish Summer Camp experience?
*
Add another child
Enroll another child
Child 2
First Name
*
Last Name
*
Gender
*
- Select -
Female
Male
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
PLEASE SELECT The WEEKS YOU would like TO REGISTER FOR
*
Week 1 (June 15 - June 19)
Week 2 (June 22 - June 26)
Name of Current School
*
Grade
*
- Select -
TK
K
1
2
3
4
5
6
swimming abilities?
*
Beginner (needs floaties)
Intermediate
Advanced (swims in DEEP-END unassisted)
biking abilities
*
Beginner (learning to bike with 2 wheels)
Intermediate
Advanced
favorite activities and interests
*
any allergies or medical conditions?
*
Yes
No
please specify
*
Add another child
Enroll another child
Child 3
First Name
*
Last Name
*
Gender
*
- Select -
Female
Male
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
PLEASE SELECT The WEEKS YOU would like TO REGISTER FOR
*
Week 1 (June 15 - June 19)
Week 2 (June 22 - June 26)
Name of Current School
*
Grade
*
- Select -
TK
K
1
2
3
4
5
6
swimming abilities?
*
Beginner (needs floaties)
Intermediate
Advanced (swims in DEEP-END unassisted)
biking abilities
*
Beginner (learning to bike with 2 wheels)
Intermediate
Advanced
favorite activities and interests
*
any allergies or medical conditions?
*
Yes
No
please specify
*
Emergency Information
Activity Subject
Name of Emergency Contact (not a parent)
*
Relationship to child
*
Phone number of Emergency Contact
*
List people authorized for pick up
*
Name of Physician in case of emergency
*
Phone number of Physician
*
Name of Dentist in case of emergency
*
Phone number of Dentist
*
Acknowledgments
*
jewish Status: I understand that JAMS is open to children from all backgrounds. Acceptance is not a validation of Jewish status.
Acknowledgments
*
Emergency Medical Treatment: I authorize any adult acting on behalf of JAMS to hospitalize or secure treatment for my child. I further agree to pay for all charges for that care and/or treatment. It is understood that, if time and circumstances reasonably permit, JAMS will try to communicate with me prior to such treatment.
Acknowledgments
*
Photo/ Audio/ Video/ Website Release: I consent to JAMS using photographs, audio recordings, and/or video footage of my child on its website and social media pages. No child’s name or personal information will be published alongside photos of minors attending JAMS.
Registration Fee
$
Payment Processor
*
Credit Card
PayPal
Chabad of West Marin
moshe@jewishwestmarin.org
|
415-910-8186
|
283 Butterfield Rd, San Anselmo, CA 94960
Powered by
ChabadSuite
log in
