Summer 2021 CIT Registration Form

Want to make a difference? Train to be a counselor? Be a leader? Then you've come to the right place! Welcome to the Counselor In Training Leadership Program at Camp Gan Israel! We're glad you're here! There are also special trips and perks to being in this program as well. Check out the CIT calendar!

For Campers (1st - 6th grade) Registration, please Click Here

Child 1*

First NameMiddle NameLast Name

Jewish/Hebrew Name:

Age*

Grade*Fall 2021

Birth Date*

MonthDayYear

Gender*

MaleFemale

Select Camp Sessions*

Session 1 - June 21 - 25 - "On the Lake"Session 2 - June 28 - July 2 - "Mountains and More"Session 3 - July 5 - 9 "At the Beach'"Session 4 - July 12 - 16 "Farm Life"Session 5 - July 19 - 23 "Gone Camping"Session 6 - July 26 - 30 "By the Riverside"

Early Care / After Care

Early Care 7:30-8:30 AMAfter Care 3:30-5:30 PM

Child 2

First NameMiddle NameLast Name

Jewish/Hebrew Name:

Age

GradeFall 2021

Birth Date

MonthDayYear

Gender

MaleFemale

Select Camp Sessions

Session 1 - June 21 - 25 - "On the Lake"Session 2 - June 28 - July 2 - "Mountains and More"Session 3 - July 5 - 9 "At the Beach'"Session 4 - July 12 - 16 "Farm Life"Session 5 - July 19 - 23 "Gone Camping"Session 6 - July 26 - 30 "By the Riverside"

Early Care / After Care

Early Care 7:30-8:30 AMAfter Care 3:30-5:30 PM

Mother's info*

First NameLast Name

Cell Phone*

Area CodePhone Number

Work

Area CodePhone Number

E-mail*Primary email

Occupation

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Father's info*

First NameLast Name

Cell Phone*

Area CodePhone Number

E-mail

Occupation

Address(if different than above)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

How did you hear of us?

Are the natural parent's of the child/ren Jewish?*

MotherFatherNeither

Did Mother convert to Judaism?

YesNo

Medical InformationAre there any medical conditions/allergies or pertinent information regarding your child, which we should be aware of?

Emergency Contact*other than parent

First NameLast Name

Phone Number*

Area CodePhone Number

Relationship*

Pediatrician & Insurance

First NameLast Name

Phone Number

Area CodePhone Number

Insurance

Policy #

Non-refundable registration fee*

1 CIT $502 CIT's $100

A non-refundable registration fee applies as part of this registration.

Total

$0.00 USD

Payment*Check, Cash, Zelle, Cash app or Venmo pay at the door.


Camp Payments must be paid in full before camper begins camp.

Agreement*

I hereby permit my child/ren to participate in all camp activities and join in camp trips on and beyond camp properties. In case of emergency, I hereby authorize the CGI to have my child taken care of by a physician in any way the situation may call for. I hereby agree to pay the camp fees.

General comments

Summer 2021 CIT Registration Form

1. CIT's Information

2. Mother

Father

3. Emergency Information

4. Payment Information

Synagogue Services

Adult Education

Youth Programs

Upcoming Events

Preschool & Infant Center

Jewish Women's Circle