CGI Register

CGI Registration Form

Camp Gan Isreal has 3 one week sessions.

Week One: June 22 - 26,
Week Two: June 29 - July 3,
Week 3: July 6 - 10
*early drop off option available

$300 per child per session*
$800 Full Summer*

Hot kosher and nutritious lunch is served daily, included with registration.

*No Jewish camper is ever turned away because of financial reasons.

*Please contact us to discuss a camp scholarship
1. Child Information
Child 1:*
First Name Middle Name Last Name
Hebrew Name:*
Birth Date:*

Month Day Year
Gender:*

MaleFemale
Grade completed in May of this year:*
Child 2:
First Name Middle Name Last Name
Hebrew Name:
Birth Date:

Month Day Year
Gender:

MaleFemale
Grade completed in May of this year:
Child 3:
First Name Middle Name Last Name
Hebrew Name:
Birth Date:

Month Day Year
Gender:

MaleFemale
Grade completed in May of this year:
Parent Information
Mother's Name:*
Prefix First Name Middle Name Last Name
Mother's Hebrew Name:*
Home Phone:*

Area Code Phone Number
Work Phone:*

Area Code Phone Number
Cell Phone:

Area Code Phone Number
E-mail:*
Father's Name:*
Prefix First Name Middle Name Last Name
Father's Hebrew Name*
Home Phone:*

Area Code Phone Number
Work Phone:*

Area Code Phone Number
Cell Phone:

Area Code Phone Number
E-mail*
3. Emergency Contact
Emergency Contact*
First Name Last Name
Phone Number*

Area Code Phone Number
Alt. Phone Number*

Area Code Phone Number
Relationship:*
Child's Primary Care Physician:*
First Name Last Name
Physician's Phone Number:*

Area Code Phone Number
Insurance:*
Any pertinent medical information: Allergies, medications etc.
4. Payment
Child 1 Enrollment:* Please choose one option. Early bird special automatically applied before March 31

First WeekSecond WeekThird WeekFull Summer
Early drop off option: 8:00 - 9:00 AM $5/day

Monday 6/22Tuesday 6/23Wednesday 6/24Thursday 6/25Friday 6/26Monday 6/29Tuesday 6/30Wednesday 7/1Thursday 7/2Friday 7/3Monday 7/6Tuesday 7/7Wednesday 7/8Thursday 7/9Firday 7/10
Late pickup option: 8:00 - 9:00 AM $5/day

Monday 6/22Tuesday 6/23Wednesday 6/24Thursday 6/25Friday 6/26Monday 6/29Tuesday 6/30Wednesday 7/1Thursday 7/2Friday 7/3Monday 7/6Tuesday 7/7Wednesday 7/8Thursday 7/9Firday 7/10
Child 2 Enrollment: Please choose one option. Early bird special automatically applied before March 31

First WeekSecond WeekThird WeekFull Summer
Early drop off option: 8:00 - 9:00 AM $5/day

Monday 6/22Tuesday 6/23Wednesday 6/24Thursday 6/25Friday 6/26Monday 6/29Tuesday 6/30Wednesday 7/1Thursday 7/2Friday 7/3Monday 7/6Tuesday 7/7Wednesday 7/8Thursday 7/9Firday 7/10
Late pickup option: 8:00 - 9:00 AM $5/day

Monday 6/22Tuesday 6/23Wednesday 6/24Thursday 6/25Friday 6/26Monday 6/29Tuesday 6/30Wednesday 7/1Thursday 7/2Friday 7/3Monday 7/6Tuesday 7/7Wednesday 7/8Thursday 7/9Firday 7/10
Child 3 Enrollment: Please choose one option. Early bird special automatically applied before March 31

First WeekSecond WeekThird WeekFull Summer
Early drop off option: 8:00 - 9:00 AM $5/day

Monday 6/22Tuesday 6/23Wednesday 6/24Thursday 6/25Friday 6/26Monday 6/29Tuesday 6/30Wednesday 7/1Thursday 7/2Friday 7/3Monday 7/6Tuesday 7/7Wednesday 7/8Thursday 7/9Firday 7/10
Late pickup option: 8:00 - 9:00 AM $5/day

Monday 6/22Tuesday 6/23Wednesday 6/24Thursday 6/25Friday 6/26Monday 6/29Tuesday 6/30Wednesday 7/1Thursday 7/2Friday 7/3Monday 7/6Tuesday 7/7Wednesday 7/8Thursday 7/9Firday 7/10
Total

$0.00

Payment:

Credit Card Other

Postal / Zip Code

Country

Should be Empty:

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CGI Registration Form

1. Child Information

Parent Information

3. Emergency Contact

4. Payment