Winter Camp CIT Registration Form 2020

CGI's "Counselor In Training" program invites 7th & 8th graders to take on responsibilities at camp. CIT's will chip in while still having fun with friends.

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 Name Middle Name Last Name

Jewish/Hebrew Name:

Age*

Grade* Fall 2018

Birth Date*

Month Day Year

Gender*

Male Female

Select Camp Days*

Aftercare 3:30 - 5:30 pm

Child 2

First Name Middle Name Last Name

Jewish/Hebrew Name:

Age

Grade Fall 2018

Birth Date

Month Day Year

Gender

Male Female

Select Camp Days

Aftercare 3:30 - 5:30 pm

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

Fill out the following info if you are a NEW CAMPER ONLY!

Mother's info

First Name Last Name

Cell Phone

Area Code Phone Number

Work

Area Code Phone Number

E-mail Primary email

Address

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

Occupation

Father's info

First Name Last Name

Cell Phone

Area Code Phone 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?

Mother Father Neither

Did Mother convert to Judaism?

Yes No

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

Emergency Contact* other than parent

First Name Last Name

Phone Number*

Area Code Phone Number

Relationship*

Pediatrician & Insurance

First Name Last Name

Phone Number

Area Code Phone Number

Insurance

Policy #

Total

$0.00 USD

Payment*


We accept Venmo, Cash App, or Zelle. 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 CIT Registration Form 2020

1. Child/ren’s Information

2. Mother

Father

3. Emergency Information

4. Payment Information

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