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Thanksgiving Week CGI Registration

Thanksgiving Week Camp
Monday, November 21 - Wednesday, November 23
9:00am-3:00pm
Kids Ages 2-12
1. Camper Information
Name*
First NameLast Name
My child is a*
Hebrew Name
Birth Date*
MonthDayYear
Gender*
MaleFemale
2. Parents information

Address*

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

Mother's Name
First NameLast Name
Mother's Hebrew Name
Cell Phone
Area CodePhone Number
E-mailPrimary email
Farther's Name
First NameLast Name
Father's Hebrew Name
Cell Phone
Area CodePhone Number
E-mailPrimary email
3. Emergency Information
Emergency Contact*
First NameLast Name
Phone Number*
Area CodePhone Number
Relationship*
Pediatrician
First NameLast Name
Phone Number
Area CodePhone Number
Important Medical Information or Other Notes
4. Payment Information
My child will be attending:
Mark each day attending*
Monday, Nov. 21Tuesday, Nov. 22Wednesday, Nov. 23
Tuition is $30 per day. No camper will be turned away due to lack of funds. For scholarship options please contact Shainy at [email protected]
Total
$0.00

Payment

Credit Card Paypal I will send in a check

Postal / Zip Code

Country

Agreement*
I am signing up my children for camp. I give my children permission to attend all trips and receive medical care in the case of emergency, G-d forbid. I agree that Camp Gan Israel, its administration and staff, will not be liable for any injury or health impairment that may occur.
Agreement*
I give Gan Israel permission to photograph and videotape my children and use the photos and videos (without using their names) as camp sees fit.
Comments
I would like to receive news and updates by email
Should be Empty:

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