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Register

Register

$40 non-refundable registration fee per camper due with registration.

 

Family Information
Family Name
       
Address
  Street
City
State
Zip
Contact Info
  Home Phone
Email
Mother
  Mother's Name
Hebrew Name
Work Phone
Cell
Father
  Father's Name
Hebrew Name
Work Phone
Cell
Emergency Contact Info
  Name
Phone
Relationship
 
 
  Name
Phone
Relationship
 
Pediatrician
  Name
Phone
Insurance Policy #
           
Camper 1 Information
     
Name
  First Name
Middle Name
Gender
 
Date of Birth
  Jewish Bday
Schools
  School
Entering Grade:
 
Health Notes
  Medication
Allergies

Sessions Attending
 
 
           
Camper 2 Information
     
Name
  First Name
Middle Name
Gender
 
Date of Birth
  Jewish Bday
Schools
  School
Entering Grade:
 
Quick Health Notes
  Medication
Allergies

Sessions Attending
 
 
           
Camper 3 Information
     
Name
  First Name
Middle Name
Gender
 
Date of Birth
  Jewish Bday
Schools
  School
Entering Grade:
 
Health Notes
  Medication
Allergies

Sessions Attending
 
 
     
IMPORTANT
All forms must be completed and submitted before your child begins camp.
Name on Card
 
Card Number
 
Expiration
 
CVV Code
  What's This?
  I authorize Camp Gan Israel to charge my card non-refundable registration fees in the amount of $

I understand that the weekly fee of $175.00 is due each Monday. I agree to indemnify and hold harmless Gan Israel and its employees in case of injury, G‑d forbid. I gave my child permission to participate in all activities and for medical treatment to be administered in case of emergency.

Please type your initials here in place of a signature

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Updates
SUMMER 2017!
Camp begins Mon 6/26 and runs through Friday 8/11!
Upcoming Events
There are no events posted at this time. Please contact us for more info about our events.