Camp Gan Israel

Address*

Mother's Name*
First Name Last Name
Hebrew Name
Cell No.
E-mail
I would like to receive news and updates by email
Father's Name*
First Name Last Name
Hebrew Name
Cell No.
E-mail
3. Emergency Contact
Emergency Contact *
First Name Last Name
Phone No.*
Relationship*
Pediatrition
First Name Last Name
Phone No.
Important Medical information, allergy or dietary restrictions or other notes.*
What do you hope your child will gain from this expeirience? *
Please check off all activities your child enjoys:

BakingDramaSportsArtWater Activities
T-shirt Size

Youth SmallYouth MediumYouth LargeAdult Small
4. Payment Method
Full Camp- $399

Weekly price- $250

Select Days - $50
No child will be turned away due to lack of funds. For scholarships, please contact Chana Braun at [email protected]
When will your child be attending?

Full CampSelect WeeksSelect Days
Selected Weeks *

Week 1: May 25-29Week 2: June 1-5
Selected Days *

Mon May 25thTue May 26thWed May 27thThu May 28thFri May 29thMon June 1stTue June 2ndWed June 3rdThu June 4thFri June 5th

Payment

Credit Card Check

Postal / Zip Code

Country

Total

$0.00
Agreements*

I am signing up my children for Camp Gan Israel, I give my children permission to receive medical care in the case of an emergency, G-d forbid. I agree that Camp Gan Israel, its administration and staff, will not be liable for any injury or health impairment that may occur.
*

I give Camp Gan Israel permission to photograph and videotape my children and use the photos and videos (without using their names) as it sees fit.
Should be Empty:

This page uses TLS encryption to keep your data secure.