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Please submit this form by

  • May 13 for all Session 1 campers (this includes Kochavim A and B, Youth A and B, CBM Experience, Chalutzim, and Chalutzim Experience)
  • June 10 for all Session 2 campers (this includes Kochavim C and D)

Please send a copy of the following

  • A photocopy of both the front and back of your child’s insurance medication card to

For prescriptions unable to be sent electronically, the physician may call them in to Arnold's (706-778-4918) where legally allowed or they can be mailed to us at 639 Irvin Street, Cornelia GA 30554.

List your child's prescriptions:
A credit card number is needed by Arnold Drug to charge for your co-pay and the $40 per camper packaging fee. Please provide the following information below:
I hereby authorize Arnold Drug Company to charge the above credit card for my insurance co-pay (or the price for the medication if my insurance plan does not accept the submission by Arnold Drug Company) and a $40 fee for packaging our prescription order.
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