Request Information - Suffolk Y JCC

Request Information Suffolk Y JCC 74 Hauppauge Road Commack, NY 11725 631.462.9800 631.462.9462-fax Please take a few moments to fully complete the fields below and we’ll be happy to send you our information.
Family name
Address, City, State
Daytime Phone
Alternate Phone
Email Address
Child One Name
Age (As of September)
Gender
Child Two Name
Age (As of September)
Gender
Child Three Name
Age (As of September)
Gender
How Did You Hear About Us?
Please Indicate Which Camps You Would Like More Information About?		Camp Wonderland (age 3 - 5) Junior Camp (grades K-5) Sports Camp (grades 4-9) On CenterStage (grades 1-9) CIT (grade 10) Young Adventurers (grades 1-4) Tween Camp (grades 6-9) Teen Travel (grades 8-10) Camp Create (grades 3-8)