How did you hear about Summer at SEM?

Family/Friend Mailed Postcard Social Media Camp Fair Returning Camper Buffalo News magazine Spree Business 1st WNY Family The Bee Elmwood Village newsletter The Public newspaper Artvoice Jewish Journal

Number of campers registering

If sisters are not registering for the same weeks, please use separate forms.

1 2 3

Camper's First Name:*

Last Name:*

Birthdate:* (mm/dd/yyyy)

School:*

Grade in Sept '18:*

T-shirt size:*

Sibling 2 First Name:*

Last Name:*

Birthdate:* (mm/dd/yyyy)

School:*

Grade in Sept '18:*

T-shirt size:*

Sibling 3 First Name:*

Last Name:*

Birthdate:* (mm/dd/yyyy)

School:*

Grade in Sept '18:*

T-shirt size:*

Parent's Name:*

Address:*

Town:*

State*

Zip code:*

Home Phone:

Cell Phone:

Choose your weeks - $350 for one week

WK 1 / June 25 - June 29 - For entering 5th and 6th graders ONLY! WK 2 / July 2 - 6 - Short week - $70 less WK 3 / July 9 - 13 WK 4 / July 16 - 20 WK 5 / July 23 - 27 WK 6 / July 30 - Aug 3

How many weeks of camp did you just choose?*

Which weeks do you need early drop off?