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Cell Phone
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Date of Birth
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Gender Identity
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Pronouns
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Shirt Size
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Local Ramah Camp
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Please provide a photo that we can share with our airport chaperones.
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How will you be arriving to camp?
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Incoming Flight Number
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Incoming Airline
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Incoming Flight Arrival Time
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How will you be departing camp?
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Departing Flight Number
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Departing Airline
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Flight Departure Time
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Upload Proof of COVID Vaccine
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Emergency Contact 1 Name
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Emergency Contact 1 Phone
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Emergency Contact 1 Relationship
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Emergency Contact 2 Name
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Emergency Contact 2 Phone
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Emergency Contact 2 Relationship
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Vaadot Preferences
At Weinstein, participants have the opportunity to join a “vaad” (committee). Each vaad will lead a different activity throughout the weekend (choices include Israeli dancing and singing zemirot on Shabbat). Select as many as you would be interested in:
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Vaad Zemirot & Seudah Shlishit
Vaad A Capella
Vaad Tefilah
Vaad Rikud
Vaad Peulat Erev
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Do you want to help lead tfillot or read Torah at Weinstein? Select as many as you would be interested in:
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Birkat Hamazon
D'var Torah
Maariv
Mincha
Shacharit
Torah Reading
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Weinstein is an amazing opportunity to meet new friends, and reconnect with old friends from your home camp. We want to help everyone participate socially and feel included. How would you describe yourself and how you socialize (e.g., quieter and keep to yourself, want to socialize but may need some support to meet people, very outgoing and not needing help socializing)
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Goals you have for attending Weinstein?
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What do you hope to gain from this experience?
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Vocational Jobs at Camp
Many of our programs with the voc-ed track will involve discussing job skills, etc.
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What jobs have you participated in at camp or during the year?
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What jobs have you enjoyed doing the most at camp or during the year?
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What do you do during the year?
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Work at a paid part time job.
Work at a paid full time job.
Work at a volunteer part time job.
Work at a volunteer full time job.
Attend a college/university.
Attend a day program.
Other (Please describe below.)
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College/University
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Graduation Year
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Other (Please describe.)
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Dietary Restrictions
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All dietary restrictions will be accommodated. Dining is buffet-style with open access to food. Participants will be responsible for managing their own dietary restrictions. Checking this box confirms you understand how meals are offered at Weinstein, and that you agree to assume responsibility for your dietary restrictions and allergies.
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I understand.
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Do you take any medications? If so, please list them here.
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Do you require support managing your medications? Support can include Weinstein staff storing medication for you and helping set reminders for you to take it. Weinstein staff cannot administer medication. If yes, please list the support required for managing them:
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Any other medical issues that are important for us to be aware of (e.g., seizures, challenges with sleep, etc? If yes, please describe.
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Any areas where you anticipate support to be required, including physical activity restrictions, situations that are upsetting/triggering?
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