Family Membership:

Is the child a JEA Member or JEA Guest?

Active JEA members receive a 20% 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.

Sessions

September 14 "Foam Party" ($40.00) [80 remaining]
October 19 "Hide & Seek" ($40.00) [97 remaining]
November 9 "Lego My Eggo" ($40.00) [99 remaining]
December 14 "Laser Tag" ($40.00) [98 remaining]
January 11 "Dive-In Movie" ($40.00) [99 remaining]
February 8 "Nacho Average Game Night" ($40.00) [99 remaining]
March 8 "Munchkin Masterpiece" ($40.00) [99 remaining]
April 26 "Fries & Dyes" ($40.00) [99 remaining]
May 17 "Manhunt" ($40.00) [99 remaining]

Child Information

Child Name

Date of Birth

Grade

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

Child's Address

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, and updates. 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

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

Emergency Contact Name

Emergency Contact Phone Number

List of Adults Authorized to Pickup Child

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.

Waiver of Liability

I, the undersigned, agree to the terms above.

Behavior Agreement Terms

I, the undersigned, agree to the terms above.

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Coupon Code

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.