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Camp Gan Israel

fun forever!

ב"ה

Camp Registration

Camp Registration
Child Information:
Child's Name*
First Name Last Name
Gender*
Birth Date*

Month Day Year
School*
Grade*

Address*

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

Phone Number*

Area Code Phone Number
Mother Information:
Full Name*
First Name Last Name
Hebrew Name*
Cell Number*

Area Code Phone Number
E-mail*
Mother is:*
Mother is:*
Father Information:
Full Name*
First Name Last Name
Hebrew Name*
E-mail*
Cell Number*

Area Code Phone Number
Father is:*
Father is:*
Emergency Contact:
Full Name*
First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
Physician Information:
Full Name*
First Name Last Name
Phone Number*

Area Code Phone Number
Child Age Group:
Please select one
*

Younger BunkOlder BunkC-Teen
Sessions - Summer 5784/2024
Camp will be July, 7 - July, 25
Please check all that apply*

Full SessionJuly 7 - 11July 14 - 18July 21 - 25
All forms must be completed and submitted before your child begins camp.

Cost per week is: $150
Lunch can be provided for an additional $25 per week.

All trips and activities are included in camp tuition.

Scholarships are available. No child will be turned away due to lack of funds. To apply for a scholarship, please contact us at: [email protected]
Tuition With Lunch
Tuition Without Lunch
Total

$0.00

Payment

Credit Card Check

Postal / Zip Code

Country

I have read the camp brochure and application form and agree to the terms stated.

I give my child permission to attend all trips, and receive medical care in the case of emergency.
Electronic Signature*
Should be Empty:

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Camp Updates

First day of camp is July 7!