Parental and Medical Consent/Financial Agreement

  • Your Information

  • Parental and Medical Consent/Financial Agreement


    Please list below caregivers who are authorized to pick up your child.


    Please provide information for one person in the Hamptons, who we can contact in case

    of emergency (if we can’t reach either parent). People listed as emergency contacts are

    authorized to pick up your child.



    1. Full camp tuition is due upon registration

    2. Due to the seasonal nature of summer camp and the set limitation of spaces offered, no refund shall be

    provided for absences, changes, or withdrawals

    3. Permission is granted for the camper to participate in all camp activities.

    4. Permission is hereby granted for photographs to be taken of the camper and the camp has the right to utilize those photographs in camp brochures, on our website and in camp print and online advertising


    I hereby give Camp Gan Israel Southampton permission to take my child to any hospital facility or outside doctor when deemed necessary. Furthermore, I hereby give permission to such hospital or outside doctor to authorize x-rays and emergency treatment if deemed necessary. I understand that all medical bills for service rendered are my responsibility.

  • I have read the enrollment agreement and understand its’ terms and accept its’ conditions.

  • I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document. By selecting "I agree" using any device, means, or action, I consent to the legally binding terms and conditions of this document.

  • Please note: a camp health form is required to be submitted online for each camper before the start of camp. You may submit the health form by clicking here.

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