Welcome to Coronado's Jewish Summer Camp! Are you a new camper to Camp Gan Israel Coronado?* YesNo Parents' Information Mother's Name* First Name Last Name Mother's Cell Phone* Mother's E-mail* Father's Name* First Name Last Name Father's Cell Phone* Father's E-mail* Parent's Status* MarriedWidowedDivorcedOther Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Please confirm if the child's mother is Jewish?* YesNo Camper's Information Camper 1 Camper 1 Full Name* First Name Last Name Camper 1 Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Camper 1 Gender* MaleFemale Add another camper Camper 2 Camper 2 Full Name* First Name Last Name Camper 2 Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Camper 2 Gender* MaleFemale Add another camper Camper 3 Camper 3 Full Name* First Name Last Name Camper 3 Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Camper 3 Gender* MaleFemale Add another camper Camper 4 Camper 4 Full Name* First Name Last Name Camper 4 Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Camper 4 Gender* MaleFemale General Information Previous Camps Attended:* How did you hear about Camp Gan Israel?* What goals would you like to see your child/ren accomplish during camp?* Briefly describe your child/ren's personality* Child/ren's favorite activities* What activities or outings has your child loved most in the past? FeesMonday - Friday | 9:30am - 2:30pm Which sessions will your child/ren be attending? $400 per session EARLY PICKUP AT 12:30 Please click here if you would like early pickup at 12:30 for your 2 years old for the special early pick up pricing of $350 per session Please indicate below how many children will attend the regular session and how many will attend early pickup, so the price can be adjusted accordingly. Please also note that hot lunch is not available for children attending early pickup. For example, if you have 2 children and one will attend the regular session while the other will attend early pickup, please fill it out as shown below. 1st Session: July 6-10 Number of children 1st Session Early Pickup: July 6-10 Number of children Would you like to include hot lunch? 1st Session, $25 per child Number of children Sandwich Options for Trip Days For trip days, please list each child and their sandwich choice from the options below: Egg, Tuna, Cream Cheese, Peanut Butter, Jelly, PB&J, American Cheese 2nd Session: July 13-17 Number of children 2nd Session Early Pickup: July 13-17 Number of children Would you like to include hot lunch? 2nd Session, $25 per child Number of children Sandwich Options for Trip Days For trip days, please list each child and their sandwich choice from the options below: Egg, Tuna, Cream Cheese, Peanut Butter, Jelly, PB&J, American Cheese 3rd Session: July 20-24 Number of children 3rd Session Early Pickup: July 20-24 Number of children Would you like to include hot lunch? 3rd Session, $25 per child Number of children Sandwich Options for Trip Days For trip days, please list each child and their sandwich choice from the options below: Egg, Tuna, Cream Cheese, Peanut Butter, Jelly, PB&J, American Cheese 4th Session: July 27-31 Number of children 4th Session Early Pickup: July 27-31 Number of children Please note that hot lunch will not be available for Session 4. Please remember to send lunch with your child(ren). As of June 1st, registration for weekly sessions will go up to $400. Full refund will be given until May 31st. No refunds as of June 1st. Camp T-ShirtsOne t-shirt is included per child. Campers are required to wear a camp t-shirt on trip days. Camper 1: Please select size* Child SmallChild MediumChild LargeAdult SmallAdult MediumAdult Large Camper 2: Please select size* Child SmallChild MediumChild LargeAdult SmallAdult MediumAdult Large Camper 3: Please select size* Child SmallChild MediumChild LargeAdult SmallAdult MediumAdult Large Camper 4 Please select size* Child SmallChild MediumChild LargeAdult SmallAdult MediumAdult Large Emergency Contact Information Contact 1: Full Name* First Name Last Name Phone Number* Relationship to child* Medical Information: Family Physician* Phone Number* Are there any medical concerns that your child's counselor should be aware of?* Permission * I hereby give permission for my child to participate in all Camp Gan Israel of Coronado activities and trips. * I also hereby consent to the administration of Camp Gan Israel to take whatever medical measures they deem necessary for my child, in the event of a medical emergency. Parent/Guardian* Date* Month Day Year Comments: Payment Details Security Fee* With todays needs of security, the security fee allows us to provide security guards daily during camp. Camp Security Fund Family security contribution - $150Sponsor a day of camp security - $450Sponsor 2 days of camp security - $900Sponsor a week of camp security - $2,250Sponsor Camp Security 2026 - $10,000.I would like to participate in camp registration only at this time Total $0.00 Payment Credit Card Paypal Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPaypal has been selected. Payment will take place on the next page. 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