Camp Registration

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!

Number of children being registered*

Full Name*

First Name Last Name

Birth Date*

Month Day Year

Sessions ($310 per session) If registering for all 5 weeks, please check ONLY the last option (Will attend all 5 weeks)*

Gender*

Pediatrician*

First Name Last Name

Phone Number*

Area Code Phone Number

Insurance Name and ID #*

Is your child up to date on all immunizations? In order to attend camp, immunization form must be submitted.*

YesNo

My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise*

YesNo

Is your child allergic to any medications? If yes, please explain

Is your child allergic to any foods? If yes, please explain

Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain

Are there any social or other challenges we should be aware of?

Full Name*

First Name Last Name

Birth Date*

Month Day Year

Gender*

Sessions ($310 per session) If registering for all 5 weeks, please check ONLY the last option (Will attend all 5 weeks)*

Pediatrician*

First Name Last Name

Phone Number*

Area Code Phone Number

Insurance Name and ID #*

My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise*

YesNo

Is your child allergic to any medications? If yes, please explain

Is your child allergic to any foods? If yes, please explain

Is your child up to date on all immunizations? In order to attend camp, immunization form must be submitted.*

YesNo

Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain

Are there any social or other challenges we should be aware of?

Full Name*

First Name Last Name

Birth Date*

Month Day Year

Gender*

Sessions ($310 per session) If registering for all 5 weeks, please check ONLY the last option (Will attend all 5 weeks)

Pediatrician*

First Name Last Name

Phone Number*

Area Code Phone Number

Insurance Name and ID #*

My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise*

YesNo

Is your child allergic to any medications? If yes, please explain

Is your child allergic to any foods? If yes, please explain

Is your child up to date on all immunizations? In order to attend camp, immunization form must be submitted.*

YesNo

Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain

Are there any social or other challenges we should be aware of?

If you have additional children, please contact us.

Full Name*

Cell Phone Number*

Home Phone Number

Address*

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

E-mail* Primary email

Full Name*

Cell Phone Number*

Home Phone Number

Address* Leave blank if same as above

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

E-mail* Primary email

Child/ren may be picked up from camp by:

Name and Relationship

Please check off if you are interested in Early or Late Care. We will reach out to you with further details.

Early Care ($15 per hour)Late Care ($15 per hour)

I would like to receive news and updates by email

Emergency Contact*

First Name Last Name

Phone Number*

Area Code Phone Number

Relationship*

I hereby give consent to the administration of Camp Gan Israel to take whatever medical measures they deem necessary, at my expense, for my child in the event of a medical emergency. I understand that, when possible, every effort will be made to contact parent/guardian or emergency contact before Camp Gan Israel will undertake such a decision.

Signature of Parent or Guardian*

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Total: (Please deduct 10% early bird discount from the total if registering and paying in full before May 15, 2026)

$0.00

I would like to pay today:Full amount10% minimum: $0.00 $

Agreement*

I am registering my child/ren for camp. I give my child/ren permission to attend all trips and receive medical care in the case of emergency, G-d forbid. I give Gan Israel permission to photograph and videotape my child/ren and use the photos and videos (without their names) for whatever the camp sees fit.

General comments

PARENTAL CONSENT: I hereby give consent for my child to participate in all activities of Camp Gan Israel (CGI) both on and off site, trips, transportation to and from trips etc., unless I advise you otherwise in writing.
Limited Guardianship Approval: I hereby consent that CGI's directors - Mrs. Faigie Wolff and Mrs. Chanie Cohen be granted limited guardianship capabilities with regards to signing waivers on behalf of my child/ren for trips specified in this year's camp schedule. (I do understand that I may still be asked to fill out waivers, as not all locations accept this consent)
PAYMENT AND CANCELLATION: Payment terms are a $50.00 non-refundable deposit per camper to accompany registration. The balance is due by June 24, and is non-refundable after that date.
DISMISSAL OF CAMPER: Parent fully understands and agrees that the Camp reserves the right to dismiss, in its sole discretion, any camper whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interests of the Camp or fellow campers or who violates camp rules and regulations. In the event of dismissal, tuition will be refunded on a prorated basis less the $50.00 registration deposit.
IMAGES, ETC.: Permission is hereby given to use in promoting the Camp and in other ventures directly relating to the Camp (i) digital, photographic and video images or likenesses of camper; audio of camper; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by camper or originating from Camp or from a Camp-related activity.
INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless Camp Gan Israel (CGI) and its officers, servants or assignees from any liability concerning our child’s involvement in CGI and further agree that the use of any premises during the CGI camp day is made at the risk of the registrant.
I have read and agree to all of the terms and conditions in this Application Form. I am including a non-refundable $50 registration deposit per camper along with submission of this form. I further agree to remit the full tuition and any other fees by June 24 as per the agreed timeline of my choice on this form.

Signature of Parent or Guardian*

Camp Registration

1. Child/ren’s Information

Child 1

Medical Information Child 1:

Child 2

Medical Information Child 2:

Child 3

Medical Information Child 3:

2. Parents' Information

Mother's Info:

Father's Info:

3. Emergency Information

4. Payment Information

5. Terms and Conditions