Camp Registration

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REGISTRATION FOR 2024 is open!!!

Please fill out the application form below. The camp director will be in touch with you within a week to confirm your application.

Click here for dates and rates.
Where did you hear about us?
Please choose the tier that matches your financial abilities.*

Tier 1 - $425 a child per weekTier 2 - $360 a child per weekTier 3 - $285 a child per week
Child/ren’s Information
Number of children being registered*
Number of children being registered*
Number of children being registered*
Child 1
Full Name*

First Name Last Name
Hebrew name
Birth Date*

Month Day Year
Gender*
Grade entering*
Sessions *

Week 1Week 2
Allergies?*

YesNo
what is your child allergic to?*
Child 2
Full Name*

First Name Last Name
Hebrew name
Birth Date*

Month Day Year
Gender*
Grade entering*
Sessions *

Week 1Week 2
Allergies?*

YesNo
What is your child allergic to?*
Child 3
Full Name*

First Name Last Name
Hebrew name
Birth Date*

Month Day Year
Gender*
Grade entering*
Sessions *

Week 1Week 2
Allergies?*

YesNo
What is your child allergic to?*

Address* Leave blank if same as above

If you have additional children, please contact us.
Parents Information
Mother name*
Mother's Phone Number*

Area Code Phone Number
Mothers E-mail* Primary email
Was mother born Jewish?*

If no, please state if there were any conversions or adoptions.
Fathers name*
Fathers phone number*

Area Code Phone Number
Father's E-mail*
Was father born Jewish?*

If no, please state if there were any conversions or adoptions.
Marital Status*

MarriedDivorcedSeparated
Does the childs other parent consent to him/her going to our camp?*

YesNo
Who may pick up your child/ren from camp?*

Name and Relationship
Emergency Contact
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
More information
Permissions* All of these must be selected. If you have a question or hesitation, email [email protected]

I hereby give permission for my child to participate in all Camp Gan Izzy activities and tripsI also hereby consent to the administration of Camp Gan Izzy to take whatever medical meaures they deem necessary for my child, in the event of a medical EMERGENCY in which they can't reach meI also authorize Camp Gan Izzy to have and use photographs, slides and videos of the person named on this application as needed for educational and public relations programs
Payment Information
Make a donation towards the camp scholarship fund

$36$50$75$100
Total

$0.00

I would like to pay today:Full amount20% minimum: $0.00 $

Payment

Credit Card Check

Please note: Your card will not be charged when clicking submit. We will be in touch before charging your card.
General comments
5. Terms and Conditions
- Limited Guardianship Approval: I hereby consent that CGI's directors - Rabbi Zalman & Mrs. Goldie Sandhaus be granted limited guardianship capabilities with regards to signing waivers on behalf of my child / children for trips specified in this year's camp schedule. (I do understand that I may still be asked to fill out waivers, as not all locations accept this consent)
- INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless Camp Gan Israel (CGI) and its officers, servants or assignees from any liability concerning our child’s involvement in CGI and further agree that the use of any premises during the CGI camp day is made at the risk of the registrant.
- Upon aprovel of this application we will send any additional necessary required forms.
Signature of Parent or Guardian*
Date & Time*

Month Day Year
at Hour Minutes
Should be Empty:

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