Camp Bnai Ruach

We are so excited to welcome you to Camp B'nai Ruach 2025.

To ensure all of our campers have the best possible experience this summer please complete all form fields.
A 5% discount for Early Bird Registration will be applied automatically before May 1.
The $60 registration fee for each family is included in the cost and is non-refundable.
CBI full members receive a discounted rate for CBR. If you are interested in joining please see our membership page.
Scholarships available for CBI members, CDC families, and USY members.
If you plan to apply for a scholarship or would like to pay via cash or check, please contact the CBI office at 714-730-9693 before filling out this form.

* Are you a current FULL Member of Congregation B'nai Israel? (Not associate or Friend of CBI)

Please Choose OneYesNo

Parent/Guardian #1 Information

* First Name

* Last Name

* Email

* Cell Phone

* Household Mailing Address

* City

* State

* Zip Code

Parent/Guardian #2 Information

First Name

Last Name

Cell Phone

Does Parent/Guardian #2 have a different household then Parent/Guardian #1?

Household Address #2 Number and Street Name

Address #2 City

Address #2 State

Address #2 Zip

* Emergency Contact Name

First & Last

* Emergency Contact Relation to Camper(s)

* Emergency Contact Phone

* Children's Physician Name

* Children's Physician Phone Number

* Insurance Name

* Insurance Policy Number

* Upload front of insurance card

You can upload a maximum of 1 files.

* Upload back of insurance card

You can upload a maximum of 1 files.

How did you hear about Camp B'nai Ruach?

Camper Information

* Camper 1 First Name

* Camper 1 Last Name

* Camper 1 Gender

MaleFemaleOther

* Date of Birth

* Grade Entering Fall 2025

* Current School

* T-Shirt Size

Extra T-Shirt? ($18)

Extra T-Shirt? ($18)1 shirt already included, this is an extra shirt

* Food Restrictions/Allergies

* Medications

* Any medical or special circumstances?

* Does this child have an IEP or 504 at school?

Camper 1 will attend:

Camper 2 First Name

Camper 2 Last Name

Camper 2 Gender

MaleFemaleOther

Date of Birth

Grade Entering in Fall 2025

Current School

T-Shirt Size

Extra T-Shirt? ($18)

Extra T-Shirt? ($18)1 shirt already included, this is an extra shirt

Food Restrictions/Allergies

Medications

Any medical or special circumstances?

Does this child have an IEP or 504 at school?

Camper 2 will attend:

Camper 3 First Name

Camper 3 Last Name

Camper 3 Gender

MaleFemaleOther

Date of Birth

Grade Entering Fall 2025

Current School

T-Shirt Size

Extra T-Shirt? ($18)

Extra T-Shirt? ($18)1 shirt already included, this is an extra shirt

Food Restrictions/Allergies

Medications

Any medical or special circumstances?

Does this child have an IEP or 504 at school?

Camper 3 will attend:

Camper 4 First Name

Camper 4 Last Name

Camper 4 Gender

MaleFemaleOther

Date of Birth

Grade Entering Fall 2025

Current School

T-Shirt Size

Extra T-Shirt? ($18)

Extra T-Shirt? ($18)1 shirt already included, this is an extra shirt

Food Restrictions/Allergies

Medications

Any medical or special circumstances?

Does this child have an IEP or 504 at school?

Camper 4 will attend:

Summer 2025 LITs

If your camper is in grades 8 or 9, we will require them to fill out the below questions. CBI has been the benefit of receiving Teen Grant funds the last few summer, which we have been using to build the next generation of Jewish leaders. We want our LITs to be excited about participation and understand their important role at camp. Please ensure your camper provides the answers; you may forward them this form to fill out or ask them to complete it below, whichever is easier.

Why would you like to be an LIT at CBR?

What do you believe is your biggest strength you can bring to camp? What do you believe is something you need to work on?

What are some hobbies or interests that you have?

CBR Refund policy:
Many of the payments, fees, and deposits required to make Camp B'nai Ruach ("CBR") the unforgettable experience it is, requires CBR to pay in advance incurring expenses which are non-refundable by outside vendors. Therefore, please bear this in mind prior to requesting refunds. NO REFUNDS WILL BE ISSUED FOR NO-SHOWS, ILLNESSES, OR INJURIES. Refunds requested will be processed according to the following schedule:

Before May 1, 2024: 100%, minus the full registration fee of $60 and any bank charges associated with credit card payments.

Permission, Release & Waiver of Liability:
By completing this enrollment form and entering my digital signature below, I as the parent or legal guardian of the above child(ren) hereby release Camp B'nai Ruach & Congregation B'nai Israel from any and all liability arising from claims for injuries or damages that either individually or on behalf of my child might occur during participation in Camp B'nai Ruach activities. I authorize any adult acting on behalf of Congregation B'nai Israel's Camp B'nai Ruach program to treat, hospitalize, or secure treatment for my child. I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Camp B'nai Ruach personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all camp activities and field trips. I understand that my child may be photographed while participating in Camp B'nai Ruach activities and that these pictures may be used for marketing purposes.

By electronically signing my name below, I accept the refund policy and all other terms and conditions.

* Electronic Signature:

Enter first & last name

* Date of Signature:

Total

Camp B’nai Ruach Summer 2025