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’s Information
Child*
First NameMiddle NameLast Name
Birth Date*
MonthDayYear
Gender*
MaleFemale
If your child has any allergies please list them here:
Camp Rates:*
One Week $299Two Weeks $547
Child 2
First NameMiddle NameLast Name
Child 2 Birth Date
MonthDayYear
Child 2 Gender
MaleFemale
If your child has any allergies please list them here:
Camp Rates:
One Week $269.10Two Weeks $492.30
If you have additional children please contact us.
2. Parent information
Phone Number*
Area CodePhone Number

Address*

Mother's info
First NameLast Name
Work Phone
Area CodePhone Number
E-mailPrimary email
Cell Phone
Area CodePhone Number
Father's info
First NameLast Name
Work Phone
Area CodePhone Number
E-mail
Cell Phone
Area CodePhone Number
How did you hear of us?
3. Emergency Information
Emergency Contact*
First NameLast Name
Phone Number*
Area CodePhone Number
Relationship*
Pediatrician & Insurance
First NameLast Name
Phone Number
Area CodePhone Number
Insurance
Policy #
4. Payment Information
Deposit due at sign-up: $50 per camper.
Due to Covid the deposit is refundable until May 1st.
Total
$0.00

I would like to pay today: Full amount$50.00 minimum $

Payment

Credit Card Paypal Check

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 their names) for whatever the camp sees fit.
General comments
Should be Empty:

This page uses TLS encryption to keep your data secure.

1. Child’s Information