Spring Camp Registration Form

Camper Information

Male Female

Schedules and Fees:

 Full Session: Tuesday, March 19 - Friday, March 22 - $100

 Per day basis - $30 per day. Please indicate in the "Notes" which days your child will be joining camp.

Method of Payment:

I will mail in a check for the full amount. Please make check payable to Chabad Youth.

Emergency Contact:

Health History and Special Instructions:

Please describe any medical conditions or behavioral issues that would be beneficial to know in caring for your child.

Please list any known allergies that your child has:

Other Notes  

Parental Consent:

I hereby permit Camp Gan Israel to transport my child(ren) on camp provided transportation, and to obtain emergency medical care as the situation mandates. I agree that Camp Gan Israel, its administration and staff, will not be liable for any injury or health impairment that may occur. My child has permission to participate in any field trip or activity done with Camp Gan Israel.