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Park Day Camp Registration 2025

June 16 - August 8

2-8 Weeks Sessions

Please complete in full. You can find the after & before care form on the website along with the medical forms, carpool information and other documents.

Parent/Guardian Information (click to open section)

A custodial parent or legal guardian must fill out all camper applications.

* Parent/Guardian 1 name

* Parent/Guardian 1 work phone

* Parent/Guardian 1 cell phone

* Parent/Guardian 1 email

Parent/Guardian 2 name

Parent/Guardian 2 work phone

Parent/Guardian 2 cell phone

Parent/Guardian 2 email

* Street Address

* City, State, Zip

Are you a member of Park Synagogue? (check yes or no)

Yes, I am a member.

No, I am not a member.

How did you hear about Park Day Camp?

Referred by

Camper Information (click to open)

* Camper's Full Name

* Camper's Birth Date (month/day/year)

* School currently attending (2024-2025 School Year)

* Current Grade (2024-2025 School Year)

* Grade as of September 2025

* What school will they attend in 2025-2026?

* Lives with:

If child's address is different from the above parental information please indicate below:

Street Address City, State, Zip

* Gender

Pronouns

* May we include camper contact information in a camp directory?

* T-shirt Size:

Session selection

2-week session - indicate weeks below

4-week session - indicate weeks below

6-week session - indicate weeks below

8-week session (June 16 - August 8)

Please select the sessions your campers will be attending.

Session 1 (Weeks 1 & 2) : June 16-June 27

Session 2 (Weeks 3 & 4) : June 30-July 11

Session 3 (Weeks 5 & 6): July 14-July 25

Session 4 (Weeks 7 & 8): July 28-August 8

Incoming Kindergarten and 1st graders are strongly encouraged to attend a minimum of four consecutive weeks

Incoming Kindergarten and 1st graders: Is your camper interested in participating in our Kayitz Kef, Hebrew Immersion Camp Group?

Do you plan to sign up your child for extended day?

Park Synagogue Member Registration Options:

Jewish Communal Rate*

Does your family hold an active annual membership to a Cleveland Synagogue?

If yes, what synagogue?

Are either parents employed by a Jewish Organization?

If yes, please provide their place of employment and position.

*The Jewish Communal Rate is available to those who hold annual membership to any Jewish Synagogue, Jewish Day School families, and Jewish Communal professionals. Documentation required.

Community Options:

Are you interested in hosting one of our Israeli Staff this summer?

Additional Camper Information

To help us best support your camper, please share any information that might help us work together to create a meaningful and positive experience. Your insights are invaluable in helping us ensure a summer filled with fun, growth, and success for your camper.

Does your child receive any of the following support services: (If your child DOES NOT receive any of these support services, please check None.)

504 Plan, Individualized Education Plan (IEP)

Individual Psychiatry Services

Group Psychiatry Services

Social/Emotional Support Services

Physical and Or Occupational Therapy

Speech/Language Therapy

Other

None

If you checked a box other than "none" please provide additional information.

Does your camper have any allergies?

Yes

If yes, please list any allergies your child has.

Camper friend requests

Please list up to two campers that your camper would like to be in a group with. We make every effort to accomodate these requests, but they are not guaranteed.