Registration

Registration for Camp Gan Israel (4-9 Years old)
Kiddie Camp (3 Years old)
and Camp Extreme (10-12 Years old)

View Dates & Rates Here >>
Registration Information
Camper 1

First Name Last Name
MaleFemale
Age
Grade (Grade Entering)
Camp Gan Israel

All 4 Weeks ($200 in savings!)Week 1Week 2Week 3Week 4
Kiddie Camp

All 2 Weeks ($100 in savings!)Week 1Week 2
Camp Extreme

All 2 Weeks ($50 in savings!)Week 1Week 2
Register Another Camper? Camper 2

Yes
Camper 2

First Name Last Name
MaleFemale
Age
Grade (Grade Entering)
Camp Gan Israel

All 4 Weeks ($200 in savings!)Week 1Week 2Week 3Week 4
Kiddie Camp

All 2 Weeks ($100 in savings!)Week 1Week 2
Camp Extreme

All 2 Weeks ($50 in savings!)Week 1Week 2
Register Another Camper? Camper 3

Yes
Camper 3

First Name Last Name
MaleFemale
Age
Grade (Grade Entering)
Camp Gan Israel

All 4 Weeks ($200 in savings!)Week 1Week 2Week 3Week 4
Kiddie Camp

All 2 Weeks ($100 in savings!)Week 1Week 2
Camp Extreme

All 2 Weeks ($50 in savings!)Week 1Week 2
Parent Info
Parent Name*

First Name Last Name
Phone Number*

Area Code Phone Number
E-mail* (For confirmation)
Use address on file

Address

Emergency Contact Information
Emergency Contact #1

First Name Last Name
Relationship to Child
Phone Number

Area Code Phone Number
E-mail
Emergency Contact #2

First Name Last Name
Relationship to Child
Phone Number

Area Code Phone Number
E-mail
Health Information
Child’s Physician or Medical Facility (name):
Phone Number

Area Code Phone Number
List any serious illnesses your child(ren) had within the past six months, including noting if your child(ren) has had history of physical handicaps, rheumatic fever, heart problems, seizures, asthma, diabetes, or other problems.
Illness or Conditions
Does your child(ren) have any allergies? If yes, please describe them and indicate special precautions or care needed.
Allergies
Please describe any instructions that would be helpful in caring for your child, or special medical information needed by the child’s care staff/provider.
Care Instructions
Registration Policies and Parental Consent
I hereby permit Camp Gan Israel to transport my child(ren) on camp provided transportation, and to obtain emergency medical care as the situation mandates. I allow my child to participate in all camp activities. I understand that tuition balance must be paid in full by the arranged with the Camp Director.
I agreeI do not agree
I allow Camp Gan Israel to use my child(ren)’s photograph for all promotional purposes.
I agreeI do not agree
Inital
Date

Month Day Year
Deposit Payment
Total Deposit

Payment

Credit Card Paypal

Postal / Zip Code

Country

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