Youth Tisha Bav Camp Event 2024

* Parent's Name

* Parent Email

* Parent phone number

* I Acknowledge that my child assumes all risks of being injured while attending the Bruce Wenger YIWH Youth Department Tish B'Av camp. I agree to hold YIWH and its officials, coordinators and all other staff harmless from any liability, loss or personal expense arising out of my child's participation in the program.

I Acknowledge that my child assumes all risks of being injured while attending the Bruce Wenger YIWH Youth Department Tish B'Av camp. I agree to hold YIWH and its officials, coordinators and all other staff harmless from any liability, loss or personal expense arising out of my child's participation in the program.

Allergy or other information we should know:

Number of Children - Member ($70 per child)

1 Child2 Children3 Children

Number of Children - Non-Member ($75 per child)

1 Child2 Children3 Children

Child 1 Full Name

Child 1 Gender

Child 1 Age

Child 2 Full Name

Child 2 Gender

Child 2 Age

Child 3 Full Name

Child 3 Gender

Child 3 Age

Total cost

Wed, May 7 2025 9 Iyyar 5785

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