Register for Camp Revach!

If you have multiple children, please fill out this form, once for each child

Camp Revach strives to promote a Bais Yaakov type environment in which your daughter feels comfortable dressing in the tzanua fashion encouraged by her family and school. We respectfully require all campers to cover their elbows and legs at all times. We aspire to provide a wholesome atmosphere in which Torah values are held high. If you think Revach is the place for you and are ready for legendary fun apply here!

Camper Information

Camper First Name:
Camper Last Name:
Grade in Sept. 2024:
Street Address:
ZIP Code:
Phone Number:
Child's Date of Birth:

Parent Information

Mother's Name:
Mother's Phone Number:
Mother's Email:
Father's Name:
Father's Phone Number:
Father's Email:
Parent's Marrital Status:

Medical Information

Doctor's Name:
Doctor's Phone Number:
Please list all Medications and/or Allergies:
Does your child have any physical limitations or restrictions?

Emergency Contact Information

Emergency Contact #1 Name:
Emergency Contact #1 Number:
Emergency Contact #1 Relationship:
Emergency Contact #2 Name:
Emergency Contact #2 Number:
Emergency Contact #2 Relationship:

Additional Information

Summer Length: 8th Grade is only 1st Half.
School Morah's Name:
How did you hear of us?
What would make your daughters summer incredible?
Bunk Request: While we try to accommodate all requests, we cannot guarantee any specific requests. Please enter up to 2 names and we will do our best to accommodate.

Transportation and Lunch (Optional)

Transportation ($200/Half, $400/Full) (Optional):

Lunch is the same options each week:

All Lunches are catered from 5 Towns Resturants and each are individually wrapped. All lunches served with fresh fruit and/or vegtables. Each meal is individually packed.

Monday Tuesday Wednesday Thursday Friday
Pizza Meat Dish Bagel with choice of spread Dairy Dish Noodle Dish
Hot Lunch ($130/Half - $260/Full Summer) (Optional):

Payment Information

Payment Method: