Scholarship Request Form - ChabadPalisades.com

SCHOLARSHIP RATES:

Registration Fee Per Camper: $50
(Includes the camp tshirt)

Scholarship Rate:
Full Summer: $2,000 ($400/Week), 1 Week: $425, 2 - 4 Weeks: $410/Week

Child's Name:*

First Name Last Name

Date Of Birth*

Month Day Year

Gender*

MaleFemale

Weeks Interested in Attending*

Name of School*

Grade entering in September 2025*

Parent/Guardian 1*

First Name Last Name

Cell Phone*

E-mail*

How did you hear about us?*

Please state reasoning for request :*