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YOUTH Camp Gan Israel

Camp Register Form

Camp Gan Israel is a camp dedicated to enriching the lives of children from diverse Jewish backgrounds and affiliations through a stimulating camping experience. CGI is part of the largest and fastest growing network of day camps, enjoying a reputation as a pioneer in Jewish camping, with innovative ideas and creative activities, to both provide enjoyment and inspire children to try new and exciting things!
1. Child/ren’s Information
Child 1*
First Name Middle Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
Sessions ($190 per session)*

Week 1Week 2
If your child will only be attending specific days, please specify here:
Child 2
First Name Middle Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Sessions ($190 per session)

Week 1Week 2
If your child will only be attending specific days, please specify here:
Child 3
First Name Middle Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Sessions ($190 per session)

Week 1Week 2
If your child will only be attending specific days, please specify here:
Child 4
First Name Middle Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Sessions ($190 per session)

Week 1Week 2
If your child will only be attending specific days, please specify here:
If you have additional children please contact us.
2. Parent information
Phone Number*

Area Code Phone Number

Address*

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

Mother's info
First Name Last Name
Work Phone

Area Code Phone Number
E-mail Primary email
MobileNumber

Area Code Phone Number
Father's info
First Name Last Name
Work Phone

Area Code Phone Number
E-mail
Mobile number

Area Code Phone Number
How did you hear of us?
3. Emergency Information
Emergency Contact*
First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
4. Payment Information
Fee: $190/ Per Week/ Per Child

Cost Per Day • $70

Time: Monday-Thursday 9.00am-3.00pm

Friday 9.00am-1.00pm

Please insure your child is picked up on-time, late pick up will incur additional charge.
Total

$0.00

Payment

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Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Agreement*

I am signing up my child for camp. I give my child permission to attend all trips and receive medical care in the case of emergency, G-d forbid.
Agreement

I give permission for my child to be photographed.
Should be Empty:

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