Camp CBI Registration Form - 2018

PRECHOOL CAMP IS TOTALLY FULL FOR THE SUMMER! ONLY FAMILIES WITH CAMPERS IN GRADES 1-9 MAY REGISTER. SORRY FOR ANY INCONVENIENCE!


Thank you for registering your child(ren) for Camp CBI! Please fill this form out completely. If you need to make changes after it has been submitted, please contact Shelby Apple at shelbyapple1@gmail.com. A reminder that preschool camp is full for the summer.

    Parent Contact Information

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    Emergency Contact Information

    The following people (local to Charlottesville) have my permission to pick up my child(ren) from camp:
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    Medical Information

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    Additional Information

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    Weekly Camp Fees for Campers Entering Grades 1 - 9

    Camp (9AM - 3:15PM) - $255 for CBI members, $280 non-members Before Care (8:00AM - 9AM) - $45 for CBI members, $50 non-members, if you sign up for less than 5 days, the daily rate is $15/day (24 hour notice required, subject to availability) After Care (3:15PM - 5:30PM) - $75 for CBI members, $85 non-members, if you sign up for less than 5 days, the daily rate is $18/day (24 hour notice required, subject to availability) Noar Teen Traveling Camp (for children entering grades 7 - 9) - PROGRAM IS NOW FULL. YOU MAY SIGN UP FOR A WAITLIST

    Weekly Camp Fees for Campers 2 years old to Kindergarten

    5 DAYS PER WEEK CAMP (9AM - 3:15PM) - $255 for CBI members, $280 non-members (9AM - 12:45PM) - $180 for CBI members, $195 non-members 3 DAYS PER WEEK CAMP (9AM - 3:15PM) - $ 175 for CBI members, $195 non-members (9AM - 12:45PM) - $135 for CBI members, $145 non-member Before Care (8:00AM - 9AM) - $45 for CBI members, $50 non-members, if you sign up for less than 5 days, the daily rate is $15/day After Care (3:15PM - 5:30PM) - $75 for CBI members, $85 non-members, if you sign up for less than 5 days, the daily rate is $25/day Babysitting Weeks - FULL!

    Child Registration - Camper #1

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    Please make sure to fill out the appropriate section below based on the age/grade of Camper #1.

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    Week 1 (June 11 - 15)
    Week 2 (June 18 - 22)
    Week 3 (June 25 - 29)
    Week 4 (July 2 - 6) *no camp July 4
    Week 5 (July 9 - 13)
    Week 6 (July 16 - 20)
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    Child Registration - Camper #2

    Please make sure to fill out the appropriate section below based on the age/grade of Camper #2.

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    Week 1 (June 11 - 15)
    Week 2 (June 18 - 22)
    Week 3 (June 25 - 29)
    Week 4 (July 2 - 6) *No camp July 4
    Week 5 (July 9 - 13)
    Week 6 (July 16 - 20)
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    Child Registration - Camper #3

    Please make sure to fill out the appropriate section below based on the age/grade of Camper #3.

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    Week 1 (June 11 - 15)
    Week 2 (June 18 - 22)
    Week 3 (June 25 - 29)
    Week 4 (July 2 - 6)*No camp on July 4
    Week 5 (July 9 - 13)
    Week 6 (July 16 - 20)
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    Important Information

    - Registration fee is $30 per family (waived for forms received by April 15) - A confirmation and bill will be emailed to you after you register. Half of your payment will be due by June 1 and the other half must be paid by July 1. - We will not be able to offer refunds.We will be happy to switch weeks you have signed up for based on availability. NOTE: There will be a $30 change fee per child for every change made after April 15

    Scholarships

    A limited number of need based scholarships are available.
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    Permisson and Release

    Please check the box below to indicate you have read and agree to the following information: 1. In case of an illness or an emergency, we will attempt to notify the parent, emergency contact person, or the child’s physician. If these attempts are unsuccessful, the child will be taken to the nearest emergency room. Any expenses incurred will be borne by the child’s family, not Camp CBI or Congregation Beth Israel. Hospitals require that, except in cases when the doctor feels it an extreme emergency, parents must be reached before children under 18 can be treated. Naturally, every effort would be made to reach a parent, but if this is impossible, we need your permission to seek aid for your child. In case of Illness, I will arrange to have my child picked up as soon as possible. In the case of an emergency, I hereby give permission for my child to be treated by a doctor selected by Camp CBI, including, but not limited to, the child’s physician, a doctor associated with that physician or an emergency room doctor. 2. I give permission for my child to participate in camp activities, including field trips and swim activities. I give permission for my child to use transportation approved by CBI, including CTS buses and private vehicles. In consideration of my child’s participation in the aforementioned activities and intending to be legally bound, I hereby waive, release and forever discharge all rights, actions, and claims which I or my child may have against Congregation Beth Israel, Camp CBI, and its officers, directors, trustees, employees, representatives, successors, assigns, and affiliates (“release”) for injury, loss, and all damages which may be sustained and or suffered in connections with participation in the aforementioned programs. 3. I give permission for photographs/video of, and artwork by, my child to be used by Camp CBI for promotional purposes. I give permission for photographs/video of my child to be included in news media coverage of activities at Camp CBI. 4. I give permission for Camp CBI staff to apply sunscreen to my child. 5. I understand that all camp fees MUST be paid by July 1st. The first payment of camp fees (half of total tuition) is due June 1 and the second half is due by July 1. All fees are non-refundable.
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    REMINDER!

    Half of your camp fees are due by June 1. A bill will be emailed to you. The remainder of your tuition will be due on July 1. Thank you for your prompt payment.

    Thank you for registering your child(ren) for Camp CBI - A summer of fun awaits!