Camp Gan Israel Registration

Parents Information
Mother's Name*

First Name Last Name
Mother's Cell Number*

Area Code Phone Number
Mother's E-mail*
Mother's Jewish Background*
Father's Name*

First Name Last Name
Father's Cell Number*

Area Code Phone Number
Father's E-mail*
Father's Jewish Background*
Camper's Information
A $50 non-refundable registration fee will be applied per child. Please complete 1 form for each child.
Child's Name*

First Name Last Name
Hebrew name (if applicable)
Birth Date*

Month Day Year
Age*

Address*

Please describe your child, and what activities he/she enjoys.* Please include anything we should know about your child as well as any allergies.
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.
Payment

Price: $275 a week, $500 for 2 weeks
My child will be attending*

Week 1 - July 18 - 22 Week 2 - July 25 - 29
I would like to pay today:*

Full amount for 2 weeks Full amount for 1 week Full amount for 1 week with sibling discount Full amount for 2 weeks with sibling discount Registration Fee of $50
Total

$50.00

Payment*

Credit Card Paypal

Postal / Zip Code

Country

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Parents Information