Family Membership:

Is the child a JEA Member or JEA Guest?

Active JEA members receive a discount.

If you are interested in exploring our membership options and benefits, please reach out to [email protected]. (Note: the membership discount can be applied retroactively, if you decide to become a member within 30 days of enrollment).

If registering as a member in error or member status is inactive on date of service, the credit card used for registration will be charged the remaining guest rate balance.

Registration:

Select all dates your child will attend.

May

22 - Thursday - D@J ($60.00)
23 - Friday - D@J ($60.00)

7AM Drop Off Add on Option

If you need to drop off before 8am, select the dates below for early morning drop off option (beginning at 7am).

7am Drop Off Add on Option

January 21 ($5.00)
January 23 ($5.00)
May 22 ($5.00)
May 23 ($5.00)

Child Information

Child Name

Date of Birth

Grade in 2024-2025

School Attending

Allergies/Medications or Any Special Accommodations the child may need:

Does your camper have an IEP/504 Plan? If yes, please elaborate.

Is there anything you would like us to know about your camper?

Child's Address

Who Does the Child Live With?

Parent/Guardian 1 Name

Parent/Guardian 1 Email

Parent/Guardian 1 Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Parent/Guardian 2 Name

Parent/Guardian 2 Email

Parent/Guardian 2 Phone Number

Emergency Contact Name

Emergency Contact Phone Number

List of Adults Authorized to Pickup Child

Terms & Permissions

Media Release Waiver

I, the undersigned, as parent and/or legal guardian of the child identified on this form, do hereby give the Jewish Educational Alliance, Inc., and JEA Children’s Department permission to use names, photographs and videos of my camper. Photographs and videos may be used for promotional, fundraising, and educational purposes and programs to promote JEA Children’s Department and future JEA programming. I hereby release the Jewish Educational Alliance, Inc., and JEA Children's Department, and all of its employees, trustees, officers, directors, volunteers, students, agents and assigns from any and all liability and financial obligations related to the use of any photography or videos of me or my dependents.

I, the undersigned, agree to the terms above.

Media Release NOT ALLOWED

Permission is not given to the media release terms listed above.

Transportation Waiver

Permission and Release to Travel
I, the undersigned, as parent and/or legal guardian of the child identified on this enrollment, do hereby give permission for my child to participate in JEA Children Department programs including any and all bus transportation. I also release, indemnify, and hold harmless the Jewish Educational Alliance, Inc. and all of its employees, trustees, officers, directors, volunteers, students, agents and assigns from any and all liability, damages, and claims of any nature whatsoever. I understand and agree that participation in any of these activities has risks of injury. Despite precautions, accidents and injuries may occur and personal injury/and or loss or damage to personal property may occur as a result of participation in this program. Therefore, I assume all risks related to the activities.
In case of an emergency I hereby assume all responsibility and costs that may be incurred for medical treatment which may be rendered to my child.
I have read and agree to comply with the terms of this waiver of liability. My signature below indicates that I have read, understood, and freely signed this agreement. I expressly agree that this agreement shall be construed and enforced in accordance with the laws of the State of Georgia, and I consent to the jurisdiction of said State. I agree that this waiver and release is intended to be as broad and inclusive as permitted under Georgia laws so that if any portion hereof is held invalid, the balance shall continue in full legal force and effect.

I, the undersigned, agree to the terms above.

Behavior Agreement Terms

I, the undersigned, agree to the terms above.

Minor Liability Waiver

I, the undersigned, agree to the terms above.

Coupon Code

**Attention!! Once you click the submit button, Payment is charged Today for all selections made.**

Employee Only Discount

If employee discount is applied in error or employee status or coupon code privilege is inactive on date of service, the credit card used for registration will be charged the remaining balance.

Registration Form

Family Membership:

Registration:

7AM Drop Off Add on Option

Child Information

Terms & Permissions