Please complete the registration for each child and then calculate the payment amounts. You can make your payments for each child individually, or pay for more than one at a time.

Ages 1 year old- 5th grade

Cost:
Rosh Hashanah: $25 each day per child
Yom Kippur: $30 per child

If your child is in 6th grade and up and interested in being a CIT or counselor for high holiday daycare, please register here.

Please note: Registration as a staff member does not guarantee acceptance.

We want all children to participate in our programs who wish to do so. If you need a scholarship or have financial hardships, please contact Ari Hoffman

Parent Information

* Parent 1 First Name

* Parent 1 Last Name

* Parent 1 Phone Number

* Parent 1 Email

* Parent 2 First Name

* Parent 2 Last Name

* Parent 2 Phone Number

* Parent 2 Email

* I would like to provide alternate emergency contact information. Different from Parent 1 and Parent 2.

* Emergency Contact Name

* Emergency Contact Phone Number

* Emergency Contact Email

* How many children are you registering for Daycare?

Child Information

* Child 1 First Name

* Child 1 Last Name

* Child 1 Age

* Is this child potty trained?

YesNo

* Child 1 Doctor

* Child 1 Doctor's Phone Number

* Child 1 Medical Insurance Carrier

* Child 1 Medical Insurance #

* Child 1 Allergies

Child 1 Medications

Child 1 Other Health Concerns

* Which days does this child need Daycare for? (Select all that apply)

Rosh Hashanah - Day OneRosh Hashanah - Day TwoYom Kippur

* Child 2 First Name

* Child 2 Last Name

* Child 2 Age

* Is this child potty trained?

YesNo

* Child 2 Doctor

* Child 2 Doctor's Phone Number

* Child 2 Medical Insurance Carrier

* Child 2 Medical Insurance #

* Child 2 Allergies

Child 2 Medications

Child 2 Other Health Concerns

* Which days does this child need Daycare for? (Select all that apply)

Rosh Hashanah - Day OneRosh Hashanah - Day TwoYom Kippur

* Child 3 First Name

* Child 3 Last Name

* Child 3 Age

* Is this child potty trained?

YesNo

* Child 3 Doctor

* Child 3 Doctor's Phone Number

* Child 3 Medical Insurance Carrier

* Child 3 Medical Insurance #

* Child 3 Allergies

Child 3 Medications

Child 3 Other Health Concerns

* Which days does this child need Daycare for? (Select all that apply)

Rosh Hashanah - Day OneRosh Hashanah - Day TwoYom Kippur

* Child 4 First Name

* Child 4 Last Name

* Child 4 Age

* Is this child potty trained?

YesNo

* Child 4 Doctor

* Child 4 Doctor's Phone Number

* Child 4 Medical Insurance Carrier

* Child 4 Medical Insurance #

* Child 4 Allergies

Child 4 Medications

Child 4 Other Health Concerns

* Which days does this child need Daycare for? (Select all that apply)

Rosh Hashanah - Day OneRosh Hashanah - Day TwoYom Kippur

* Agree

AgreeI give permission for my child(ren)’s counselors to administer emergency first aid to my child(ren) if needed, and to seek the assistance of medical professionals if the situation requires. I understand that Camp Yavneh will make every effort to contact me immediately if emergency first aid is administered. I understand that my child(ren) may not attend Camp Yavneh unless I give permission for emergency medical treatment.

* Agree

AgreeI acknowledge that I am placing my child(ren) in High Holiday daycare, which is a service provided by BCMH. I further acknowledge that the program incorporates some vigorous physical activity and interaction with other children, and that such activities by their nature carry inherent risk of injury. I hereby certify that my child(ren) are fit, physically and otherwise, to participate fully in all activities. In consideration of my being allowed to place my child(ren) in high holiday daycare and intending to be legally bound, I hereby waive, release, hold harmless, covenant not-to-sue, and forever discharge any and all rights, actions or claims of negligence that I or my heirs, executors or assigns may have against Bikur Cholim – Machzikay Hadath, its officers, employees, agents, and leaders, for death, injury, loss and any and all damages that I or my child(ren) may sustain and/or suffer in connection with my child(ren)’s participation in High Holiday DaycareCamp Yavneh. I also agree to indemnify BCMH for any defense, cost, or expense arising out of any claim of damages, injury, or death arising from my child(ren)’s participation in High Holiday daycare.

Total:

High Holiday Daycare 2025

Please complete the registration for each child and then calculate the payment amounts. You can make your payments for each child individually, or pay for more than one at a time.