Camp Registration "*" indicates required fields Step 1 of 18 5% Primary Contact (About You)Please complete ONE APPLICATION for each family.Name* First Last Email* Enter Email Confirm Email Phone*Do not include +Gender*MaleFemaleDate of Birth* MM slash DD slash YYYY Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands More InformationOccupationHave you attended Shoshanah before Yes No If yes, which years?ExperienceJew or Gentile? (Optional) Jew Gentile How many years have you been a believer?Please enter a number greater than or equal to 0.How much Bible background do you have? 1 2 3 4 5 Level 1 -5 (1=low 5=high)Add Family MembersWill your spouse be attending?* Yes No Emergency Contact InformationName* First Last Emergency Telephone*Do not include +Relationship to you* Health and AllergiesDo you have any health issues we should be aware of?* Yes No Do you have any allergies we should be aware of?* Yes No HealthHealth - Please check all that apply* Asthma Autism Spectrum Bleeding / Clotting Disorder Diabetes Epilepsy / Convulsions Heart Condition Hearing Impaired Visually Impaired Mobility Impaired Other - Respond Below Do you carry an inhaler?* Yes No Not Applicable Other:Describe if your health issue is not listed AllergiesAllergies - Please check all that apply* Animals Foods Insect Stings Medication Pollen Poison Ivy/Oak/Sumac Other - Respond Below Do you carry an Epi-Pen?* Yes No Not Applicable Other:Describe if your allergy issue is not listedList any food allergiesPlease separate each with a comma, Your SpouseName* First Last Phone*Do not include +Gender*MaleFemaleDate of Birth* MM slash DD slash YYYY More InformationOccupationHas your spouse attended Shoshanah before? Yes No If yes, which years?ExperienceJew or Gentile? (Optional) Jew Gentile How many years has your spouse been a believer?Please enter a number greater than or equal to 0.How much Bible background do they have? 1 2 3 4 5 Level 1 -5 (1=low 5=high)Health and AllergiesDo they have any health issues we should be aware of?* Yes No Do they have any allergies we should be aware of?* Yes No HealthHealth - Please check all that apply Asthma Autism Spectrum Bleeding / Clotting Disorder Diabetes Epilepsy / Convulsions Heart Condition Visual Impaired Hearing Impaired Mobility Impaired Other - Respond Below Do you carry an inhaler?* Yes No Not Applicable Other:Describe if your health issue is not listed AllergiesAllergies - Please check all that apply* Animals Foods Insect Stings Medication Pollen Poison Ivy/Oak/Sumac Other - Respond Below Do you carry an Epi-Pen?* Yes No Not Applicable Other:Describe if your allergy is not listedList any food allergiesPlease separate each with a comma, Register Youth and Children17 years or youngerWould you like to register youth or children?* Yes No Register Youth <div class="repeater-field-header"> <div class="repeater-field-header-title">Child <span class="repeater-field-header-count">1</span></div> <div class="repeater-field-header-acctions"> <ul> <li><i class="repeater-icon icon-down-open repeater-field-header-acctions-toogle" aria-hidden="true"></i></li> <li><i class="repeater-icon icon-cancel-1 repeater-field-header-acctions-remove" aria-hidden="true"></i></li> </ul> </div> </div> Name* First Last Relationship to you*Please select RelationshipSonDaughterNephewNieceFriendGender*MaleFemaleDate of Birth* MM slash DD slash YYYY Student ProficiencyLevel 1 -5 (1=low 5=high)Entering Grade*Please enter a number from 0 to 12.Age Group* Path Finders (2yrs - 5yrs) Light Bearers (6yrs - 9yrs) Word Seekers (10yrs - 13yrs) Truth Keepers (14yrs - 17yrs) Reading Skill Level* 1 2 3 4 5 Writing Skill Level* 1 2 3 4 5 Fluency in English* 1 2 3 4 5 Health HistoryDo they have any health issues we should be aware of* Asthma Autism Spectrum Bleeding / Clotting Disorder Diabetes Epilepsy / Convulsions Heart Condition Visual Impaired Hearing Impaired Mobility Impaired Other - Respond Below No Medical Conditions Please check all that applyDo they carry an inhaler?* Yes No Not Applicable Other:Describe if your health issue is not listedAllergies* Animals Foods Insect Stings Medication Pollen Poison Ivy/Oak/Sumac No Allergies Do you carry an Epi-Pen?* Yes No Not Applicable Other:Describe if your allergy is not listedList any food allergiesPrayer Requests for your child Class SchedulePlease check which week(s) you would like to attend:* Week 1: Jun 30 – Jul 4 Week 2: Jul 7 – Jul 11 Week 3: Jul 14 – Jul 18 Week 4: Jul 21 – Jul 25 Week 5: Jul 28 – Aug 1 Week 6: Aug 4 - Aug 8 Week 7: Aug 11 – Aug 15 Week 8: Aug 18 – Aug 22 Labor Day Weekend Conference: Aug 29 -Sep 1 Number of WeeksExcluding Labor Day WeekendPLEASE MAKE A NOTE OF THE WEEKS AS YOU WILL NEED TO CONFIRM AFTER SELECTING ACCOMODATION. AccomodationsWhile we have many different levels of accommodations, some are limited in number and are on a first come – first served basis. However, we cannot guarantee that your requested level of accommodation will be available. Also, please note that there are no private rooms, unless you are a married couple or family. If there is room to accommodate such a request, we will happily do so – however it is not guaranteed. Check-In Time: Saturday 2 PM to 9 PM and Sunday 8 AM to 4 PM. Check-out/departure time is Saturday morning by 9:30 AM. Choose your Accommodation* Commuter - No Meals Commuter - With Meals Tent Site RV Site Basic Cabin Value Room Lakeside Condo * Basic Cabin = no A/C no bathroom ** Lakeside Condo = A/C and bathroom *** Sorry, no single private rooms are availableRate total will be calculated based on your selections. Cost Calculation for AdultsWeeks AttendingExcluding Labor Day WeekendWEEKS ATTENDING MUST MATCH YOUR ACCOMODATION WEEK SELECTIONCommuter - No Meals*1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 Week# Adults*Please enter a number from 1 to 2.Commuter - With Meals*1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 Week# Adults*Please enter a number from 1 to 2.Tent Site*1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 Week# Adults*Please enter a number from 1 to 2.RV Site*1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 Week# Adults*Please enter a number from 1 to 2.Basic Cabin*1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 Week# Adults*Please enter a number from 1 to 2.Value Room*1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 Week# Adults*Please enter a number from 1 to 2.Lakeside Condo*1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 Week# Adults*Please enter a number from 1 to 2.Cost Calculation for Youth and ChildrenNumber of Children*Please enter a number from 1 to 10.Children (2-17)*Select Weeks1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 WeekSubtract Free Child Discount (2-17)None1 Week2 Week3 Week4 Week5 Week6 Week7 Week8 WeekFamily Special: Three (3) or more children - One (1) is FREE Cost Calculation Labor Day WeekendLabor Day Weekend how many people? Quantity$500 per person for the entire weekend (non-refundable). Price: $500.00 Quantity Begins with Shabbat dinner on Friday evening. Seating begins promptly at 5:45PM. Check-in/arrival is between 10:00AM and 3:45PM on Friday. Check-out/departure is Monday by 2:00PM. Those planning to stay after week 8 until Labor Day should contact the Campus Office for cost information. A minimum deposit (10% of total or $100, whichever is greater) must accompany application. Installments can be made, with the total being paid no later than 30 days prior to your arrival. Ariel Ministries has established a scholarship fund to aid those who wish to seriously study the scriptures through Ariel’s Program of Messianic Studies. Pastors and missionaries receive priority. To apply for a partial scholarship please contact the Campus office for an application form. Submit the completed form along with the camp application and the payment/deposit, to the address below. APPLICATION WILL NOT BE PROCESSED WITHOUT A DEPOSIT.50% of amount paid is refunded up to 60 days before your arrival. No refunds given if canceling less than 60 days before arrival. NO refunds available for Labor Day Weekend program regardless of when canceling.Total and Payment InformationTotal $ A deposit is required at the time of application (10% or $100.00 – whichever is greater) PLEASE MAKE A NOTE OF THE AMOUNT AS AFTER SUBMITTING YOUR APPLICATION YOU WILL BE DIRECTED TO MAKE PAYMENT. Terms and Conditions* I understand that classes are MANDATORY for myself, and anyone included in my party Camp is an alcohol-free campus. The exception is wine consumed as part of the Erev Shabbat service on Friday’s. Due to our surroundings, smoking is prohibited. If a fire is started by a member of my group, I/we will be responsible to pay all fees associated in fighting the fire and replacing any & all building/equipment damaged or destroyed. No illegal drugs. No exceptions. Weapons & Explosives Policy: Firearms, knives (excluding pocketknives with blades 3.5” or less), swords, bows & arrows, crossbows, clubs, daggers, explosives or Fireworks are not allowed on Ariel Ministries property, unless direct permission is given by the Camp Director. Pets: Only certified guide dogs/animals are allowed, with proof of such status & vaccination records provided to the Shoshanah Camp Director prior to your arrival. Quiet Hours: I/we will respect my/our roommates and/or neighbors & others on the Camps grounds by observing quiet hours from 11pm to 6am daily. I understand that Camp Shoshanah is in the Adirondack Mountains. The roads on the Camps land are not paved and that the terrain is uneven. I will contact the Camp office if have a mobility issue, prior to arriving to camp. Tuition must be paid in full one (1) month prior to arrival. Audio/Photo/Video Release* I agree to the Audio/Photo/Video ReleaseI/we grant permission for audio and video recordings as well photographs of myself/family to be used for promotional purposes on behalf of Ariel Ministries. Such promotion may include but is not limited to the web site, Facebook pages or printed materials like brochures, posters, and flyers for Ariel Ministries and/or Camp Shoshanah. Acknowledgment of Risk, Waiver of Liability, and Consent for Treatment* I agree to the Acknowledgment of Risk, Waiver of Liability, and Consent for Treatment I/we acknowledge that there are risks inherent in any camp program, including but not limited to injury or death arising from: participating in sports activities; waterfront activities, adventure activities, failure to follow instructions/camp rules (posted, written or verbal); communicable illness; and independent acts of third parties not under the control of Ariel Ministries management. I/we acknowledge that all risk cannot be prevented and assume those beyond the control of Ariel Ministries. Further, I/we hereby fully and forever waive, release, acquit, hold harmless, and discharge Ariel Ministries from any and all claims, demands, rights, losses, suits, actions and causes of action, obligations, damages, costs, or expenses of any nature relating to injury of any type suffered during or otherwise arising from attending the 2025 Camp Shoshanah summer program. I/we agree to pay for damage to and/or loss of any applicable water sports equipment including kayaks, life jackets, etc., I and/or my family uses and will return all items in the same condition as received. I/we agree to pay for all damages to the facilities of Ariel Ministries caused by any negligent, reckless, or willful actions by me or my family. I/we agree to allow Ariel Ministries to share the medical/medication information provided with the appropriate staff or medical care providers/EMS as needed, to ensure myself, my spouse, and my child(ren)’s health and safety. Sharing Contact with Summer Program Attendees I agree to Share Contact Information with Summer Program AttendeesI give permission for my/our name, e-mail address and/or mailing address to be shared with summer program attendees, if requested.
