High Holiday Daycare

Registration & Payment

Step One: If you have not already done so, register all children using the form below.

Step Two: Add the applicable Holiday days to the cart (Click “continue shopping” to return here)

Step Three: Increase the number of children in the cart for each holiday and click “Update Cart”

Step Four: Proceed to check out and pay for High Holiday Daycare

If you have a child who is in 6th grade or higher and the child is interested in being a CIT or counselor for High Holiday daycare program, please submit an application here.

Please note: Submitting an application does not guarantee acceptance. Please contact Ari Hoffman for more information about the program.

Ages: 1 year old – 5th grade

Cost:

Rosh Hashanah Day 1: $30 per child
Rosh Hashanah Day 2: $30 per child
Yom Kippur: $40 per child

Registration Form

Parent Name(s) *

Mother's Cell *

Father's Cell *

Mother's email *

Father's email *

Child's Name *

Child's Age *

Days Attending *
Rosh Hashana Day 1Rosh Hashana Day 2Yom Kippur (Day)

Child's Doctor *

Child's Doctor's Phone # *

Medical Insurance Carrier *

Medical Insurance # *

Allergies *

Medications *

Other health concerns *

Is your child potty trained? *
YesNo

I 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 Congregation BCMH will make every effort to contact me immediately if emergency first aid is administered. I understand that my child(ren) may not attend High Holiday Daycare unless I give permission for emergency medical treatment.

I 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 Daycare. 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.

Additional emergency contacts if different from mother and father

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High Holiday Daycare

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