Camper Information
First Name
Last Name
Hebrew Name
Gender
Select
Male
Female
Date of Birth
Grade
Allergies
Note
Parent 1
Relation
Father
Mother
First Name
Last Name
Cell Phone
Email
Parent 2
Relation
Mother
Father
First Name
Last Name
Cell Phone
Email
Family Information
Address
City
State
Zip
Home Phone
Marital Status
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Married
Divorced
Single
Widowed
Have there been any adoptions or conversions in the family?
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No
Yes
If yes, please explain
Emergency Information
Name
Phone
Relation
Enrollment Options / Tuition & Fees
Please check which weeks your child will be attending.
Week 1 | June 29 - July 3
Week 2 | July 6 - July 10
Week 3 | July 13 - July 17
Choose Division
Mini Gan Izzy | Ages 3-4 ($329/week, All weeks: $950)
Sabra | Ages 5-9 ($339/week. All weeks: $980)
Pioneer | Ages 10-13 ($349/week, All weeks: $1,000)
Other Options
After Care | 3-4pm ($50/week. All weeks: $135)
Extra T-Shirt $18
I'd like to help by covering the processing fee of 3% for the tuition fees.
Tution fees will be charged upon acceptance of your child prior to the start of camp. A registration fee of $45 will be charged upon submitting this form. This is in addition to the tuition.
LAST DAY! Register before April 15th, 2026 to get a 5% discount on the tuition fees.
Payment Information
Registration Fee
$45 - Registration Fee
Card Type
Visa
MC
Amex
Discover
Number
Expiration
Code
Use contact info above
Name
Address
Zip
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Camp Gan Israel to hospitalize or secure treatment for my/our child, I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Camp Gan Israel personnel will try, but are not required, to communicate with me/us prior to such treatment. It is also understood that Camp Gan Israel can take photos and videos of your child and display them on the camp website and otherwise publicize them.
I agree to the terms and conditions above
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Yes, I agree.
Submit
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