REGISTER NOW FOR SUMMER 2016!

Please fill out the form below carefully. When you press submit, this form will be sent to our administration office.


Register Online

Please fill out the form below:

Camper 1 Camper 2 Camper 3
Campers Full Name Campers Full Name
Campers Full Name
Hebrew Name
Hebrew Name
Hebrew Name
Date of Birth
Date of Birth
Date of Birth
Gender
Gender
Gender
School Attending
School Attending
School Attending
Entering Grade
Entering Grade
Entering Grade
General Information
Previous Camps Attended
How did you hear about Camp Gan Israel?
What goals would you like to see your child/ren accomplish during camp?
Briefly describe your child/ren's personality

Child/ren's favorite activities
Fees

Full Session: $550/Child plus $15/week for food
Weekly Session: $190/Child plus $15 for food.
If registered after June 1st, then it $200/week plus $25/week for food

Week 1 (July 25 - July 29)
Week 2 (August 1 - August 5)
Week 3 (August 8- August 12)


Daily Option: $50/Child. Must be registered at least a week in advance.

For daily option, please specify which days:
Early Care Program (from 7:00am) ($10/day; $35/week)
Week 1 Week 2 Week 3
Monday Tuesday Wednesday Thursday Friday
After Care Program (till 5:30pm) ($10/day; $35/week)
Week 1 Week 2 Week 3
Monday Tuesday Wednesday Thursday Friday
T-shirt. Camp fees include one camp t-shirt, mandatory to be worn on all trip days. Additional shirts are available at $15 ea.
Child Small Medium Large
Adult Small Medium Large
Total Amount, to be paid in full by June 15, 2015
Parents' Information
Parents' Status Married Widowed Divorced Seperated
Home phone
Home Address
City
State
Zip
Father's full name
work phone
cell phone
email
Mother's full name
work phone
cell phone
email
Comments
Emergency Contact Information
Contact 1
Phone
Relationship to child
Contact 2
Phone
Relationship to child
Family Physician
Phone
Are there any medical concerns that your child's counselor should be aware of?
List all persons authorized to pick-up camper from campus.
Permission
I have read the camp's terms and conditions and agree to the terms and conditions stated.

Email me a record of this registration to:

Parent/Gaurdian Date


Payment Details
Registration is confirmed with minimum of $100 deposit per child.
Payment is needed in full by the first day of camp.
Last Name Total charge amount
First Name Card Type
Address Card Number
City Exp. Date
State CVV code 3 digits on back of card
Zip Comments