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Camper 1 Camper 2 Camper 3
Camper's Full Name Camper's Full Name
Camper's Full Name

Date of Birth
Date of Birth
Date of Birth
School Attending School Attending
School Attending
Entering Grade Entering Grade
Entering Grade
General Information
Previous Camps Attended
How did you hear about Camp Aleph?
What goals would you like to see your child/ren accomplish during camp?
Briefly describe your child/ren's personality

Child/ren's favorite activities
Tuition Fees

1st Session: July 1 - July 5         2nd Session: July 8 - July 12
Pioneers (Girls entering Grades 7-9): July 1 - 5 Pioneers: July 8 - 12

 Early Bird (before March 15) 5%
Rate A: 1 Week: $350 $370   •   2 Weeks: $665  $700
Rate B: 1 Week: $299 $315   •   2 Weeks: $570 
What is Rate A and Rate B? 

Rate A: 1 Week:  $399 $425   •   2 Weeks:  $750 $800  

Rate B: 1 Week: $349 $375   •   2 Weeks: $650   $700

 1 Week - July 1-5:  $399 $425 

Special promo! Thanks to a grant from the Jewish Youth Network of the Bay Area, first-time campers can join Camp Aleph with one week free of charge. Details here    
Scholarships available. Contact us at 707.559.8585

Camp Aleph T-shirts
1 T-Shirt is included per child. Additional T-Shirts - $15
Campers are required to wear a Camp T-Shirt on trip days.
Child Small Medium Large
Adult Small Medium Large
Scholarship Fund

  Every Jewish child deserves a quality Jewish Summer Camp Experience.
Contact us at 707.559.8585 and we will be glad to help.

If you are in the position to contribute to the scholarship fund, please consider doing so below.

 $180   Half Scholarship - $350   Full Scholarship - $650    Other $ 
Parents' Information
Parents' Status 
Married In a Relationship Widowed Divorced Separated Single Parent
Home Phone
Home Address

Parent (Guardian) #1
Full Name


Cell Phone

Work Phone
Jewish?  Yes  No   •   Converted?  Yes  No

Parent (Guardian) #2
Full Name


Cell Phone

Work Phone
Jewish?  Yes  No   |   Converted?  Yes  No
Emergency Contact Information
Contact 1
Relationship to child
Contact 2
Relationship to child
Family Physician
Are there any medical concerns that your child's counselor should be aware of?
I hereby consent to the administration of Camp Aleph to take whatever medical measures they deem necessary for my child, in the event of a medical emergency
I hereby give permission for my child to participate in all Camp Aleph activities and trips (if applicable)
Parent/Guardian Date

Payment Details
$50 deposit per child per week. We will email you to confirm your child's acceptance to Camp Aleph.
Please indicate in "comments" when you would like us to charge the additional amount.
Payment is needed in full before June 1.

Grant Application Pending (first time campers)

First Name   Today's charge amount
Last Name   Card Type
Address   Card Number
City   Exp. Date
State   CVV code 3 digits on back of card
Zip   When should we charge the balance?