Winter Camp Registration Form 2021

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!

Child 1*

First NameMiddle NameLast Name

Jewish/Hebrew Name:

Age*

Birth Date*

MonthDayYear

Gender*

MaleFemale

Select Camp Days (Prices are more for preschoolers)*

Aftercare (not available for preschool)3:30 - 5:30 pm

Child 2

First NameMiddle NameLast Name

Jewish/Hebrew Name:

Age

Birth Date

MonthDayYear

Gender

MaleFemale

Select Camp Days (Prices are more for Preschoolers)

Aftercare (not available for preschool)3:30 - 5:30 pm

Child 3

First NameMiddle NameLast Name

Jewish/Hebrew Name:

Age

Birth Date

MonthDayYear

Gender

MaleFemale

Select Camp Days (prices are more for preschoolers)

Aftercare (not available for preschool)3:30 - 5:30 pm

If you have additional children please use the general comments section below.

The Following Info. is for New Campers ONLY

Mother's info

First NameLast Name

Cell Phone

Area CodePhone Number

Work

Area CodePhone Number

E-mailPrimary 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 #

Total

$0.00 USD

Payment*


We accept Venmo, Zelle or Cash App. For Check or Cash please pay at the door.

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

Winter Camp Registration Form 2021

1. Child/ren’s Information

2. Mother

Father

3. Emergency Information

4. Payment Information

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