Camp Keetov, DC: Summer 2026 Registration

Welcome to Camp Keetov!

Please complete this form to register for Camp Keetov at the WHC’s DC Location! Camp Keetov - DC is available to children ages 2-5.

Questions? Please visit our website for more information or contact Jill Weiner, Director E-T ECC, jweiner@whctemple.org.

FULL SCHEDULE & TUITION

CHILD'S INFORMATION

First Name

Last Name

Prefers to be called

Date of Birth

Pronoun

Current Age Group

ECC Enrollment Status

Are you a current WHC Early Childhood Center family?

YesNo

Is your child enrolled in a non-WHC early childhood program?

YesNo

Name of School/Program

Camp Total

Extras Total

Grand Total

Family Information

Street Address

City

State

Zip Code

Child lives with

Parent/Guardian 1Parent/Guardian 2Other(s)

PARENT / GUARDIAN 1

First Name

Last Name

Email Address

Phone Number

Relationship to Child

PARENT / GUARDIAN 2

First Name

Last Name

Email Address

Phone Number

Relationship to Child

Is there an additional address you would like to provide for this person?

YesNo

Street Address

City

State

Zip Code

OTHER

First Name

Last Name

Email Address

Phone Number

Relationship to Child

Enrollment Contract

I wish to enroll my child in Camp Keetov Summer 2026. With the submission of this form, I am also making a non-refundable and non-transferable payment to Washington Hebrew Congregation for the required

$250 security fee and $

application fee for each child I enroll.

All non-refundable fees must be paid in full at the time of application. I understand that I will be billed and charged the balance of the camp tuition to the credit card or account provided within one business week.

I understand that I will be billed and charged 50% of the balance of camp tuition to the credit card or account provided within 1 business week and the remaining 50% will be charged on March 15, 2026.

I understand that I may withdraw my child from camp and receive a 90% refund of tuition up until April 15, 2026. After April 15, 2026, all tuition payments are non-refundable and non-transferable. I understand that my WHC account must be current in order for this application to be processed.

Adjustments to registration can be made until April 15. After that date, there are no refunds, and any program transfer requests are at the Director’s discretion and must be submitted to Jill Weiner at jweiner@whctemple.org.

All programs are pending sufficient enrollment and age groups may be combined.

Sibling Discount: 5% off lower tuition

I have read and agree to all of the terms outlined above

Yes

Parent's Electronic Signature

Date

Payment Information

TOTAL COST

Security Fee Subtotal

Application Fee Subtotal

Camp Tuition Total

Subtotal

$

Admin Code (Staff Use Only)

Enter Admin Code

Amount Due Today

$

Refund policy

PAYMENT METHOD

How would you like to pay your bill?

Credit Card (includes 3% fee)ACH (Direct Bank Debit - No fee)

CREDIT CARD INFORMATION

To help defray some of WHC's credit card processing costs, a 3% fee has been added to your credit card payment. Please note that ACH payments do not include this fee.

Fee Amount

$

Grand Total

$

First Name on Card

Last Name on Card

Credit Card Number

Expiration Month

Expiration Year

CVV

Different billing address?

Billing Street

Billing City

Billing State

Billing Zip Code

ACH INFORMATION

Personal check with labels for routing and account numbers

Bank Routing Number

Bank Account Number

Bank Account Type

CheckingSavings

Bank Name

Account Holder's Name (NOTE: If this is a joint account, use one name only. If it's a trust/foundation use one first/last name only)

Different billing address?

Billing Street

Billing City

Billing State

Billing Zip Code

Publicly Hidden Fields

Payment Section

Hide Payment Info

Hidden

Portal Pre-Fill Fields

Account ID

Contact ID

Outreach/Event Pre-Fill

OutreachID

DesignationID

Auth.net Connector Billing Info

Gateway Address

Gateway City

Gateway State

Gateway Zip

Gateway Totals

Gateway Quantity

Gateway Amount

Authnet_Hidden_Fields

Security Deposit Total (after discount code)

Application Fee Total (after discount code)

Waitlist Fee Total (after discount code)