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Upcoming Events Past Events Camp Gan Israel

Registration

Child 1:*

First Name Last Name
Hebrew Name:
Birth Date:*

Month Day Year
Age:*
School:
Entering Grade:*
Does your child have any social difficulties? If yes, please describe:
Child's current Jewish experience:
Child requires on outings (provided by parent)*

Car Seat Booster Seat N/A
I am signing up my child for:*

Week 1 (6/28-7/2) Week 2 (7/5-7/9)
Child 2:

First Name Last Name
Hebrew Name:
Birth Date:

Month Day Year
Age:
School:
Entering Grade:
Does your child have any social difficulties? If yes, please describe:
Child's current Jewish experience:
Child requires on outings (provided by parent)

Car Seat Booster Seat N/A
I am signing up my child for:

Week 1 (6/28-7/2) Week 2 (7/5-7/9)
Mother's Name:*

First Name Last Name
Child/ren's birth mother is*

Jewish from birth Jewish through conversion Not Jewish

Address:*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Cell Phone:*

Area Code Phone Number
E-mail:*
Parent 2 Name:

First Name Last Name

Address (if different):

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Cell Phone:

Area Code Phone Number
E-mail:
Emergency Contact:*
Relationship to Child:*
Phone Number:*

Area Code Phone Number
Family Physician:
Phone Number:

Area Code Phone Number
Is there any medical or other information (allergies, etc.) regarding your child(ren) that we should be aware of?
I hereby consent to the administration of Camp Gan Israel to take whatever medical measures they deem necessary for my child(ren) in the event of a medical emergency*

Yes No
I hereby give permission to Camp Gan Israel to take my child(ren) off camp property on field trips, outings and swimming*

Yes No
I hereby allow my child to be photographed while participating in the Camp Gan Israel activities and that these pictures may be used for marketing purposes.*

Yes No
CGI is adhering to local COVID guidelines. CGI is not responsible for children contracting COVID during camp.
One Week $175. Two Weeks $300.

Early bird special (before May 31):

One Week $155. Two Weeks $285.

Sibling Discount

Bring a Jewish friend and receive 10% off!
Fees:*
Total

$0.00

Payment*

Credit Card Check

Postal / Zip Code

Country

Should be Empty:

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