Camper Registration

Name*

First Last

Name camper prefers to be called*

Address*

Street Address Address Line 2 City State / Province / Region

Home Phone Number*

Email*

Date of Birth*

Gender*

Parental Information

Father's Name*

Father's Cell #*

Father's Email*

Mother's Name*

Mother's Cell #*

Mother's Email*

Name, Address, Tel. of relative or friend etc. if parents are unavailable*

Relationship to Child*

Educational Information

School/Yeshiva*

Grade Completed as of June 2017*

Name of Teacher*

Teacher's Email*

Principal's name*

Principal's email*

Medical Information

Allergies or Medical Issues*

Kupah*

Name of Doctor*

Doctor's Phone Number

Camp Policies Agreement

Yair Leolam Boys Program – Mission and Policies

The Yair Leolam Boys Summer Program is geared for Bnei Torah, giving them an opportunity to maintain their loyalty to the values of Talmud Torah and Gemilut Chasadim as well as provide them with fun activities to rejuvenate during the summer zman. Yair Leolam aims to promote every camper’s potential in both learning and Jewish leadership. Each camper will participate in morning seder with a dynamic educator and will learn bchavrutah/shiur on a daily basis. In addition, campers will volunteer on a variety of chessed activities and will learn strategies about becoming an effective “volunteer - leader”. Campers will have many opportunities to play ball, go on tiyulim, and participate in a host of social and recreational activities throughout the summer program. In an effort to maintain a Torah Hashkafa, please read the program’s rules and expectations carefully:

Campers will show derech eretz toward each other, staff members, and guest speakers.
Campers will participate in activities in a positive manner.
Campers will not leave campus without staff permission and parents will inform the camp of any deviation from the camp schedule
Campers will be responsible for their learning materials and the cleanliness of the facility.
Campers are requested not to bring any electronic devices that show movies (such as an ipod, MP4 players, etc…).
Campers should dress in an appropriate fashion for a ben torah (pants are required during learning).

Yair Leolam Girls Program – Mission and Policies

The Yair Leolam Girls Summer Program is geared towards Bnot Torah. The program provides an opportunity to strengthen an appreciation of our values of Torah and Gemilut Chasadim. The Yair Leolam Girls Summer Program aims to promote every camper’s potential in Jewish leadership through its program, which is designed to develop an understanding of Torat Chessed. Volunteer opportunities (both in and out of BS/RBS) and chessed based learning and activities as central components of the daily schedule. In addition, arts, swimming, tiyulim, recreational activities, BBQ’s and more are planned in order to ensure an enjoyable and fulfilling summer experience in a safe and structured environment.

In an effort to maintain a Torah Hashkafa, please read the program’s rules and expectations carefully:

Campers will show derech eretz toward each other, staff members, and guest speakers.
Campers will participate in activities in a positive manner.
Campers will not leave campus without staff permission and parents will inform the camp of any deviation from the camp schedule
Campers will respect the facility, maintain its cleanliness, and avoid participation in any form of destructive activity.
Campers are requested not to bring any electronic devices that show movies (such as an ipod, MP4 players, etc…).
Campers should dress in an appropriate fashion for a Bat Torah.

Please check off to confirm the above*

I have read the above and am committing to following the rules and policies

Parental Information

Educational Information

Medical Information

Camp Policies Agreement

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