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Camp Registration

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Registration 2022

Please fill out the form below:

Camper 1 Camper 2 Camper 3
Campers Full Name Campers Full Name
Campers Full Name
Date of Birth
Date of Birth
Date of Birth
Gender
Gender
Gender
School Attending School Attending
School Attending
Entering Grade Entering Grade
Entering Grade
           
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
 
Fees

1st Session: July 5 - 8
2nd Session: July 11 - 15
3rd Session: July 18 - 22

Each session costs $300 per week | lunches provided at $20 per week

Monday-Friday 9:30am-2:30pm

 
Camp T-shirts
Camp T-Shirt
1 T-Shirt is included per child.
Campers are required to wear a Camp T-Shirt on trip days.

Child Small Medium Large
Adult Small Medium Large
Parents' Information
Parents' Status Married Widowed Divorced 
Home Phone
Home Address
City
State
Zip
Father's Full Name

Cell Phone
Email
Mother's Full Name

Cell Phone
Email
Comments
         
Emergency Contact Information
Contact 1
Phone
Relationship to child
 
Contact 2
Phone
Relationship to child
 
Family Physician
Phone
   
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


Payment Details
Last Name   Total charge amount
First Name   Card Type
Address   Card Number
City   Exp. Date
State   CVV code 3 digits on back of card
Zip   Comments
 
 
 

 

 

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