Camp Bonim

Camper's Full Name

Father full name and work, cell #

Mother full name and work, cell #

Home Phone #

Address

Postal Code

Birth date of camper

Emergency Contacts and Numbers (one per line)

Allergies If applicaple

If Other, specify

Is there anything else we should know about your child?

Health care #

Expiry Date

Select a Package

Package A- 175$ per session

Package B- 550$

I will pay on the first day of camp in the form of

Camper's preferred jersey number to wear on back of T-Shirt. Please select more than one number since some may want the same number that you wish to have.

Enter number(s) here:

Shirt size

Email Address