');document.write('');document.write('');document.write('');function CheckPage79548aac64(){ var nResult = 0; nResult += NotEmpty( nResult, 'fld_f40a853eda','Name' ); if ( nResult == 0 ) { if (0) { var el = document.getElementById( 'frm_f35682eff3' ); if ( typeof(el)=='object' && el != null ) if (arguments[0] == 1) { el.submit(); } else Preview(1,0); } else ChangePage( 0, 1 ); }}document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('

');document.write(' Camper Information');document.write('
');document.write(' Enter camper information please. ');document.write('
');document.write(' Name *');document.write('	');document.write(' ');document.write('
');document.write(' Middle Initial');document.write('	');document.write(' ');document.write('
');document.write(' Last Name *');document.write('	');document.write(' ');document.write('
');document.write(' Address line 1');document.write('	');document.write(' ');document.write('
');document.write(' Address Line 2');document.write('	');document.write(' ');document.write('
');document.write(' Gender *');document.write('	');document.write(' Male ');document.write('Female');document.write('
');document.write(' Grade (As of Sep. 2010) *');document.write('	');document.write(' ');document.write('
');document.write(' Date of Birth');document.write('	');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write('');document.write(' ');document.write('
');document.write(' Camper e-mail');document.write('	');document.write(' ');document.write('
');document.write(' Shirt Size');document.write('	');document.write(' ');document.write('
');document.write(' School Name');document.write('	');document.write(' ');document.write('
');document.write(' Synagogue Name');document.write('	');document.write(' ');document.write('
');document.write(' Camper Lives With');document.write('	');document.write(' ');document.write('
');document.write(' ');document.write('
');document.write('
');document.write('');document.write('

');document.write(' ');function CheckPagec32ee850ea(){ var nResult = 0; nResult += NotEmpty( nResult, 'fld_571ad4dd3c','Father/Guardian Name' ); nResult += NotEmpty( nResult, 'fld_8d28aed06a','Father/Guardian email' ); nResult += NotEmpty( nResult, 'fld_0202c084be','Father/Guardian Home Phone' ); nResult += NotEmpty( nResult, 'fld_a640a26f0d','Mother/Guardian Name' ); nResult += NotEmpty( nResult, 'fld_50e2d7dfbe','Mother/Guardian email' ); nResult += NotEmpty( nResult, 'fld_e213cfc24e','Mother/Guardian Home Phone' ); if ( nResult == 0 ) { if (0) { var el = document.getElementById( 'frm_f35682eff3' ); if ( typeof(el)=='object' && el != null ) if (arguments[0] == 1) { el.submit(); } else Preview(1,0); } else ChangePage( 1, 2 ); }}document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('

');document.write(' Parent / Guardian Information');document.write('
');document.write(' Enter camper information please. ');document.write('
');document.write(' Father/Guardian Name *');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian email *');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian Home Phone *');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian Cell Phone');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian Work Phone');document.write('	');document.write(' ');document.write('
');document.write(' ');document.write('
');document.write(' Mother/Guardian Name *');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian email *');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian Home Phone *');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian Cell Phone');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian Work Phone');document.write('	');document.write(' ');document.write('
');document.write(' Referred By');document.write('	');document.write(' ');document.write('
');document.write(' If parents divorced / legally separated: who has custody?');document.write('	');document.write(' Father ');document.write('Mother');document.write('
');document.write(' ');document.write('
');document.write('
');document.write('');document.write('');document.write('

');document.write(' ');function CheckPage5235a2b97d(){ var nResult = 0; if ( nResult == 0 ) { if (1) { var el = document.getElementById( 'frm_f35682eff3' ); if ( typeof(el)=='object' && el != null ) if (arguments[0] == 1) { el.submit(); } else Preview(1,0); } else ChangePage( 2, 3 ); }}document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('');document.write('');document.write('');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('

');document.write(' Season / Grade Selection and Payment');document.write('

');document.write(' Please indicate the appropriate Session and Grade Level (2010 - 2011 school year)');document.write('

');document.write(' Session / Grade:');document.write('

');document.write(' ');document.write('

');document.write('');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('

');document.write(' ');document.write(' ');document.write('
');document.write(' Dates and Rates for the appropriate Session and Grade');document.write('Level');document.write('(2010-2011 school year):');document.write('
	Tuition');document.write('	Canteen');document.write('	Gratuity');document.write('	Total');document.write('
');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Full Season (Sunday, June 27th - Friday, August 13th)');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Grades 3-8');document.write('	$6,650');document.write('	$125');document.write('	$60');document.write('	');document.write('$6,835');document.write('
');document.write('Grades 9-10');document.write('	$6,950');document.write('	$125');document.write('	$60');document.write('	$7,135');document.write('
');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('First Session (Sunday, June 27th - Friday, July 23rd)');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Grades 3-8');document.write('	$4,895');document.write('	$100');document.write('	$60');document.write('	$5,055');document.write('
');document.write('Grades 9-10');document.write('	$4,945');document.write('	$100');document.write('	$60');document.write('	$5,105');document.write('
');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Second Session (Sunday, July 25th - Friday, August 13th)');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Grades 3-8');document.write('	$3,760');document.write('	$100');document.write('	$60');document.write('	$3,920');document.write('
');document.write('Grades 9-10');document.write('	$4,020');document.write('	$100');document.write('	$60');document.write('	$4180');document.write('
');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Rookie Session');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Grades 3-6, Session A (Sunday, June 27th - Friday, July 9th)');document.write('	$2,060');document.write('	$75');document.write('	$60');document.write('	$2,195');document.write('
');document.write('Grades 3-6, Session B (Sunday, July 25th -');document.write('Friday, August 6th)');document.write('	$2,060');document.write('	$75');document.write('	$60');document.write('	$2,195');document.write('
');document.write('	');document.write('	');document.write('	');document.write('	');document.write('
');document.write('Pioneers: Chalutzim');document.write('
(Sunday,');document.write('June 27th � Friday, August 13th)
Grade 11	Contact camp office for more information

Staff-In-Training:');document.write('Ohr Machar
(Sunday,');document.write('June 27th � Friday, August 13th)
Grade 12	Contact camp office for more information

');document.write(' ');document.write('Tuition');document.write('includes weekly professional laundry service; 1 BBPC t-shirt;');document.write('out-of-camp trip expenses (admission, food, transportation, lodging and');document.write('extra spending money); all in-camp programs, activities and supplies;');document.write('t-shirt for special programs; transportation on select dates to/from');document.write('the Long Island, Rockland, Westchester, Maryland or Philadelphia area. ');document.write(' ');document.write(' Canteen');document.write('is a pre-paid account with which campers may purchase ice cream, snack');document.write('food and drinks, toiletries, stamps, camp supplies and Perlman Gear at');document.write('the Camp Canteen. ');document.write(' ');document.write(' Gratuity: In');document.write('accordance with American Camp Association guidelines, individual');document.write('tips/gratuities are not permitted. A gratuity fund has been established');document.write('to benefit all summer camp staff. ');document.write(' ');document.write(' Sibling Discount:');document.write('Families registering more than one child will receive a discount of');document.write('$100 per additional Full Season, Pioneer or PIE camper and $50 per');document.write('additional First, Second or Rookie Session camper. This amount does not');document.write('apply to the $750 deposit required for each camper. SIT campers are not');document.write('eligible for sibling discounts. Applicable discounts will be reflected');document.write('on the account statement.

');document.write('');document.write('

');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write('

');document.write('
');document.write('Deposit:
');document.write('A $750 deposit is required with each application. The remaining balance is due no later than April 1, 2010.');document.write('Applications that are received after April 1, 2010 must include a $1500 deposit with the remaining balance due no later than June 1, 2010.
');document.write('
');document.write('Before submitting the form, please click the Preview button.
');document.write('If all the data is correct, print the form and mail it along with payment to:
');document.write('B\'nai B\'rith Perlman Camp
');document.write('4 Professional Drive, Suite 122
');document.write('Gaithersburg, MD 20879

');document.write('Thank you. ');document.write('

');document.write('

');document.write(' ');document.write('

');document.write('

');document.write('');document.write('');document.write('');document.write('

');document.write(' ');document.write(''); function Preview(to_show, to_hide ){ var tbl_hide = document.getElementById( aId[to_show] ); var tbl_show = document.getElementById( aId[to_hide] );checktags(); if ( typeof(tbl_hide)=='object' && tbl_hide!=null ) if ( typeof(tbl_show)=='object' && tbl_show!=null ) { tbl_hide.style.display = 'none'; tbl_show.style.display = ''; } tbl_pre=document.getElementById(aId[1]); tbl_pre.style.display='none'; }function submit(){ var el = document.getElementById( ); if ( typeof(el)=='object' && el != null ) el.submit();}function checktags(){ var inputList = document.getElementsByTagName("INPUT"); for(i=0; i=0)) { document.getElementById(inputList[i].id+'qzimg').style.display=""; document.getElementById(inputList[i].id+'qzimg').src='file:///'+inputList[i].value; } } } if(inputList[i].type=='checkbox') { if(inputList[i].checked==true) { var nn=inputList[i].name.substr(0, inputList[i].name.lastIndexOf("[")); document.getElementById(nn+'qz').innerHTML+=(inputList[i].value+" "); } } if(inputList[i].type=='radio') { if(inputList[i].checked==true) { document.getElementById(inputList[i].name+'qz').innerHTML=inputList[i].value; } } } var selectList = document.getElementsByTagName("SELECT"); for(i=0; i');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('');document.write(' ');document.write(' ');document.write(' ');document.write(' ');document.write('

');document.write(' Name *');document.write('	');document.write(' ');document.write('
');document.write(' Middle Initial');document.write('	');document.write(' ');document.write('
');document.write(' Last Name *');document.write('	');document.write(' ');document.write('
');document.write(' Address line 1');document.write('	');document.write(' ');document.write('
');document.write(' Address Line 2');document.write('	');document.write(' ');document.write('
');document.write(' Gender *');document.write('	');document.write(' ');document.write('
');document.write(' Grade (As of Sep. 2010) *');document.write('	');document.write(' ');document.write('
');document.write(' Date of Birth');document.write('	');document.write(' ');document.write('
');document.write(' Camper e-mail');document.write('	');document.write(' ');document.write('
');document.write(' Shirt Size');document.write('	');document.write(' ');document.write('
');document.write(' School Name');document.write('	');document.write(' ');document.write('
');document.write(' Synagogue Name');document.write('	');document.write(' ');document.write('
');document.write(' Camper Lives With');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian Name *');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian email *');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian Home Phone *');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian Cell Phone');document.write('	');document.write(' ');document.write('
');document.write(' Father/Guardian Work Phone');document.write('	');document.write(' ');document.write('
');document.write('
');document.write(' Mother/Guardian Name *');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian email *');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian Home Phone *');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian Cell Phone');document.write('	');document.write(' ');document.write('
');document.write(' Mother/Guardian Work Phone');document.write('	');document.write(' ');document.write('
');document.write(' Referred By');document.write('	');document.write(' ');document.write('
');document.write(' If parents divorced / legally separated: who has custody?');document.write('	');document.write(' ');document.write('
');document.write(' Session / Grade:');document.write('	');document.write(' ');document.write('
');document.write('
');document.write('
');document.write(' ');document.write(' ');document.write(' ');document.write('

');document.write('');document.write('');document.write('');