Camp Gan Israel Registration

Camp Gan Israel Registration

Register your child for an unforgettable summer at Camp Gan Israel! Please provide family and camper details below.
July 27 - August 7 | 9:00am - 3:00pm | Ages 5-12
Camper Information
Camper Full Name

First NameLast Name
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Grade entering this fall
Gender

Other
Does your child have any allergies or medical conditions?
If you selected yes, please specify
Parent/Guardian 1 Information
Parent/Guardian 1 Full Name

First NameLast Name
Relationship to Camper
Parent/Guardian 1 Email
example@example.com
Parent/Guardian 1 Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 2 Information
Parent/Guardian 2 Full Name

First NameLast Name
Relationship to Camper
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact/Authorized Pickup 1
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact/Authorized Pickup 2
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Additional Consent Options
Emergency Medical Treatment - I hereby give my consent to Alef Academy to call a doctor or emergency medical service and for that doctor or emergency service to provide emergency medical or surgical treatment to my child.
Media Release - I hereby grant my permission for my child's photo to be taken and used in newsletters, flyers, and/or for any other advertisement purposes.
I acknowledge the camp's health and safety policies
Camp Handbook
I have read and agree to the terms in the camp handbook
Additional Comments or Special Instructions
FORMS

Please upload the following forms. If you do not have them available please email them to cgi@chabaddenvernorth.com before July 27.
General Medical Health Form

Cancelof
Immunization Record

Cancelof
Payment

Price includes a $50 non refundable security fee for full time security on the premises.

Week 1 (Jul 27-31)

360 + 50 security fee

$410.00 Quantity

Week 2 (Aug 3-7)

360 + 50 security fee

$410.00 Quantity

Full 2 Week Program

720 + 50 security fee

$770.00 Quantity

Enter coupon

Total

Payment Methods

Debit or Credit Card

ACH Bank Transfer

Should be Empty:

Camp Gan Israel Registration

July 27 - August 7 | 9:00am - 3:00pm | Ages 5-12

Camper Information

Parent/Guardian 1 Information

Parent/Guardian 2 Information

Emergency Contact/Authorized Pickup 1

Emergency Contact/Authorized Pickup 2

Additional Consent Options

FORMS

Payment

Price includes a $50 non refundable security fee for full time security on the premises.