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Register Online!

Register Online!

Early Bird Special: 5% discount and a FREE CAMP SHIRT for registrations received by February 1st.
10% discount for registrations paid in full by April 1st. Sign up before June 1st and your deposit goes towards your tuition!

Note: Please use a separate form for each child.

Camper/Parent Information
Name
  First
Hebrew Name
Last
Male
Female
Address
  Street
City
State
Zip
Date of Birth
  Age :
Contact Info
  Home Phone
Father Email
Mother Email
 
Schools
  School
Current Grade:
Child's Mother
  Mother's Name
Hebrew Name
Work Phone
Cell
Child's Father
  Father's Name
Hebrew Name
Work Phone
Cell
Emergency Contact Info
  Name
Phone
Relationship
 
Pediatrician
  Name
Phone
   

Referred By

  First time camper?  
           
Select Child's Program
Primary Camp
Mini Gan Izzy  

Boys Division
Mini GI Extended  
Girls Pioneer
Boys Pioneer  
Please indicate which weeks your child will attend camp:

Week 1 Week 2 Week 3 Week 4 Week 5

    Click for camp dates & rates
IMPORTANT
All forms must be completed and submitted before your child begins camp.
 
 

 
 
 
 
 

I hereby register my child in Camp Gan Israel and give permission for my child to participate in all camp activities, including trips and swimming. I understand that camp does not assume responsibility for any injury, and in case of emergency, necessary medical attention may be secured by the camp. A medical form will be sent to you after registration.

A $50.00 registration fee is required with your application. To receive a 10% discount please pay in full by May 1st. Special payment arrangements must be made before camp starts. If no special arrangement is made, the camp tuition will be charged to this credit card on a weekly basis.

Please initial here:

Amount* .00
Card Type*
Card Number*
Expiration Date*
CVV Security Code What's This?
Name on card

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