Campers that are active JEA members will receive a 20% discount per date selected
All sales are final
JEA reserves a place for your child, hires staff and purchases supplies according to registration. Therefore, no refunds or credits will be given for Kids' Night Out.
Registration is required before attending.
Drop off and pick up is located in the JEA Front Lobby
Dinner is not provided; snacks are included at KNO
A $10 late fee will be added to the balance for any registration completed after 6:00 pm on the Thursday prior to the event attending

Please fill out one registration per camper.

Select the dates your child is attending

Is the Camper a JEA Member or JEA Guest?

JEA Member
JEA Guest

Family members of the JEA save 20% on JEA Children's Department Programming. If you are interested in exploring our membership options and benefits. Please reach out to [email protected].

Participants must be a current member at the time of service to receive member pricing, regardless of when payment for service was received.

Sessions*

May 4 [72 remaining]
Price $36.00
Attend This Session

JEA Employee Discount

Full Time Staff Member
Part Time Staff Member

Processing Fee

$0.00

Total

$0.00

Camper's Information

Camper's Name

Address

Date of Birth

Grade

Please list all allergies, medications or any special accommodations the child may need:

Parent/Guardian 1 Name

Parent/Guardian 1 Phone Number

Yes, it's okay to communicate with me by text message. Message frequency varies. Message and data rates may apply.View our terms of service & privacy policy.

Parent/Guardian 1 Email Address

Parent/Guardian 2 Name

Parent/Guardian 2 Phone Number

Yes, it's okay to communicate with me by text message. Message frequency varies. Message and data rates may apply.View our terms of service & privacy policy.

Parent/Guardian 2 Email Address

Emergency Contact

Phone Number - Emergency Contact

List of Authorized Persons to pick up child

Behavior Agreement Terms

I, the undersigned, agree to the terms above.

Liability Waiver

Permission and Release to Travel and Liability

I, the undersigned, as parent and/or legal guardian of the child identified on this enrollment, do hereby give permission for my child to participate in JEA Children Department programs including any and all bus transportation. I also release, indemnify, and hold harmless the Jewish Educational Alliance, Inc. and all of its employees, trustees, officers, directors, volunteers, students, agents and assigns from any and all liability, damages, and claims of any nature whatsoever. I understand and agree that participation in any of these activities has risks of injury. Despite precautions, accidents and injuries may occur and personal injury/and or loss or damage to personal property may occur as a result of participation in this program. Therefore, I assume all risks related to the activities.

In case of an emergency I hereby assume all responsibility and costs that may be incurred for medical treatment which may be rendered to my child.

I have read and agree to comply with the terms of this waiver of liability. My signature below indicates that I have read, understood, and freely signed this agreement. I expressly agree that this agreement shall be construed and enforced in accordance with the laws of the State of Georgia, and I consent to the jurisdiction of said State. I agree that this waiver and release is intended to be as broad and inclusive as permitted under Georgia laws so that if any portion hereof is held invalid, the balance shall continue in full legal force and effect.

I, the undersigned, agree to the terms above.

Media Release Waiver

I, the undersigned, as parent and/or legal guardian of the child identified on this form, do hereby give the Jewish Educational Alliance, Inc., and JEA Children’s Department permission to use names, photographs and videos of my camper. Photographs and videos may be used for promotional, fundraising, and educational purposes and programs to promote JEA Children’s Department and future JEA programming. I hereby release the Jewish Educational Alliance, Inc., and JEA Children's Department, and all of its employees, trustees, officers, directors, volunteers, students, agents and assigns from any and all liability and financial obligations related to the use of any photography or videos of me or my dependents.

I, the undersigned, agree to the terms above.

Checkbox

Media Release NOT ALLOWED
Permission is not given to media release terms listed above.

If registering as a member in error, the credit card used for registration we will be charged the remaining guest rate balance.

JEA Employees

Billing Information

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

Phone Number

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