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Youth & Teens Camp Gan Israel

Camp Registration

YES, I WOULD LIKE TO REGISTER MY CHILD!
1. Child Information
Camper Name:*

First Name Last Name
Hebrew Name:*
Date of Birth:*

Month Day Year
Grade Entering as of August 2023:*
What size T-shirt does he/she wear?* Every child that comes to CGI gets a custom made Camp T-shirt
Please choose 2 preferences for sandwiches:

Cream CheeseTunaEgg SaladHummusPeanut Butter Peanut Butter and Jelly
Please choose bread preference:

White Rye BreadWhite PitaWhole Grain Ezekiel BreadPlain Bagel
Does your child swim?

YesNo
Does your child have an IEP or special needs we should be aware of?

YesNo
What are your child’s interests, hobbies, and talents?
Please upload a recent picture of your child!
I would like to register another child
Child 2: Full Name:

First Name Last Name
Child 2: Hebrew Name:
Child 2: Birth Date:

Month Day Year
Child 2: Grade Entering as of August 2023:
Child 2: What size T-shirt does he/she wear? Every child that comes to CGI gets a custom made Camp T-shirt
Child 2: Aftercare (3-4pm):

Week 1 ($30)
Please choose 2 preferences for sandwiches:

Cream CheeseTunaEgg SaladHummusPeanut Butter Peanut Butter and Jelly
Please choose bread preference:

White Rye BreadWhite PitaWhole Grain Ezekiel BreadPlain Bagel
Does your child swim?

YesNo
Does your child have an IEP or special needs we should be aware of?

YesNo
What are your child’s interests, hobbies, and talents?
Please upload a recent picture of your child!
2. Parent information
Name:*

First Name Last Name
Phone Number:*

Area Code Phone Number
E-mail:* Primary email
E-mail: Secondary email
3. Emergency Information
Medical / Allergy Info:*
Pediatrician:*

First Name Last Name
Pediatrician Phone Number:*
Emergency Contact:*
Emergency Contact Phone:*
Relationship:
4. Payment Information

Price includes registration fee, camp t-shirt, hot kosher lunch daily, nutritious snacks daily.
Sessions:*

Week 1 ($250)Week 1 with sibling discount ($225)
Child 2: Sessions:

Week 1 ($250)Week 1 with sibling discount ($225)
I would like to sponsor a camper:

$250
Total:

$0.00

Payment:*

Credit Card Paypal eCheck Check

Postal / Zip Code

Country

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. I give Gan Israel permission to photograph and videotape my children, and use the photos and videos (without names) for communication purpose.
Parents - please specify the reasons you choose to send your child to our camp!
Should be Empty:

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