Camp Registration Form

CAMP GAN ISRAEL REGISTRATION
Camp Gan Israel is a camp dedicated to enriching the lives of children from diverse Jewish backgrounds and affiliations through a stimulating camping experience. CGI is part of the largest and fastest growing network of day camps, enjoying a reputation as a pioneer in Jewish camping, with innovative ideas and creative activities, to both provide enjoyment and inspire children to try new and exciting things!
1. Child/ren’s Information
Child 1*

First Name Last Name Hebrew Name
Birth Date*

Month Day Year
Gender*

Male Female
Grade Entering
Weeks Attending*

Week 1 July 3-7 Week 2 July 10-14
Tshirt Size
Please indicate any medical, allergy, behavioral or IEP information
Child 2

First Name Last Name Hebrew Name
Birth Date

Month Day Year
Gender

Male Female
Grade Entering
Weeks Attending

Week 1 July 3-7 Week 2 July 10-14
Tshirt Size
Please indicate any medical, allergy, behavioral or IEP information
Child 3

First Name Last Name Hebrew Name
Birth Date

Month Day Year
Gender

Male Female
Grade Entering
Weeks Attending

Week 1 July 3-7 Week 2 July 10-14
Tshirt Size
Please indicate any medical, allergy, behavioral or IEP information
Early Care/After Care

8am - 9am l $20 a week per child 3pm - 5:30pm l $35 a week per child
2. Parent information
Home Phone Number*

Area Code Phone Number

Home Address*

Mother's info

First Name Last Name
Work Phone

Area Code Phone Number
E-mail Primary email
Cell Phone

Area Code Phone Number
Father's info

First Name Last Name
Work Phone

Area Code Phone Number
E-mail
Cell Phone

Area Code Phone Number
How did you hear of us?
3. Emergency Information
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
4. Payment Information
Payments

Pay Deposit Only for 1 Child Pay Deposit Only for 2 Children Pay Deposit Only for 3 Children
Total

$0.00

Payment

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Agreement*

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.
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CAMP GAN ISRAEL REGISTRATION