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Camp Gan Israel
fun forever!

Register

Register


To register, please fill out carefully. Tuition for camp is $250 per week.

When you press submit, this form will be sent to our administration office.

Note: Please use a separate form for each child.

Camper/Parent Information
Name
First
Middle
Last
Address
Street
City
State
Zip
Date of Birth
Contact Info
Phone
Email
Schools
School
Hebrew School Entering 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

Email

Please indicate if you will need before care or after care: (additional fee)

Before Care 8:00 - 9:00AM After Care 3:00 - 4:00 PM
IMPORTANT
I will be paying by: Check Mastercard Visa Amex

Card Number

Expiration Date (mm/yy)
Cardholder
Name
Total Amount
I give my child permission to attend all trips, and receive medical care in the case of emergency.
Date of Application:

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