Camp Gan Israel of Gilbert

Summer 2017, July 3 - July 14

Registration Form

Camper's information:

Last name: First name:

Hebrew name: Male Female

Date of Birth: Age as of 6/20/16:

Grade entering: Name of School:

Any Jewish education please specify:

T-shirt size:

Early Care 8am - 9am l $20 a week

After Care 3pm - 5:30pm l $35 a week

 

Camper #2:

Last name: First name:

Hebrew name: Male Female

Date of Birth: Age as of 6/20/16:

Grade entering: Name of School:

Any Jewish education please specify:

T-shirt size:

Early Care 8am - 9am l $20 a week

After Care 3pm - 5:30pm l $35 a week

 

Camper #3

Last name: First name:

Hebrew name: Male Female

Date of Birth: Age as of 7/1/15:

Grade entering: Name of School:

Any Jewish education please specify:

T-shirt size:

Early Care 8am - 9am l $20 a week

After Care 3pm - 5:30pm l $35 a week


Parent's information:

Father:

Name:

Home phone:

Work phone:

Cell phone:

Email:

Address:

Mother:

Name:

Home phone:

Work phone:

Cell phone:

Email:

Address:

 

Medical information:

Currently taking these medications:

Allergies:

Child's doctor:

Doctor's phone number:

 

Emergency contact information:

Emergency contact:

Relation to camper:

Home phone:

Work phone:

Cell phone:

 

Comments:

Payment information: Click here for dates and rates

I'm registering child/ren for camp.

Please charge my credit card $50 deposit for each child. (deposit is applied to camp fees)

Additionally please charge my credit card towards my child/rens session/s

Yes! Please add a donation of to the CGI Scholarship Fund

I'm paying by check or cash (Make checks payable and mail to Chabad of Gilbert 4475 E. Carriage Way, Gilbert AZ 85297)

Card number:

CVV security code:

Expiration: Month Year:

Card zip code

Email confirmation to:

 

Register by May 12, 2017 and save $25 a week on your camp fees.

 

Application Information:

Tuition fees & Refund policy:

A $50 deposit is due upon registration and is non refundable. Your child's place is secured upon receipt of the $50 deposit. Camp cost is $165 per week. All fees must be paid by June 26th. A discount of $25 per week will be applied if registration and the $50 deposit is submitted by May 12, 2017.

Permissions:

I hereby permit Camp Gan Israel to transport my child(ren) on camp provided transportation. My child has permission to participate in any field trip or activity done with Camp Gan Israel of Gilbert. Camp Gan Israel will make every effort to insure the well-being of every camper. However, it will not be responsible for any injury or health impairment of any camper. Gan Israel will not be responsible for damage to or loss of clothing or personal belongings.

I allow Camp Gan Israel to use my child(ren)’s photograph for all promotional purposes.

In the event of an emergency, illness, or accident, Camp Gan Israel has my permission to arrange any necessary first-aid or care by a paramedic or licensed physician for my child/ren while he/she is attending camp.

I agree to all the terms & information listed herein.

Signature of parent or legal guardian