Online Registration!

Please fill out the form below carefully. When you press submit, this form will be sent to our administration office.

Note: Please use a separate form for each child.

Camper/Parent Information
Name
  First
Middle Last  
Address
  Street
City State
Zip
Date of Birth
   
Contact Info
  Phone
Email
 
Schools
  School
Hebrew School Entering Grade:
Child's Mother
  Mother's Name
Hebrew Name Work Phone Cell
Child's Father
  Father's Name
Hebrew Name Work Phone Cell
Emergency Contact Info
  Name
Phone Relationship  
Pediatrician
  Name
Phone     

Email

     
           
Select Child's Age Group

Ages 2 1/2 - 4 YEARS

MINI GAN ISRAEL

Ages 5-10 YEARS

GAN ISRAEL

 
 
 
 
   
 
 
Please indicate number of sessions your child will attend camp:
 

                                                 

     
IMPORTANT
All forms must be completed and submitted before your child begins camp.
I will be paying by: Check Mastercard Visa
I have read the camp brochure and application form and agree to the terms stated. I give my child permission to attend all trips, and receive medical care in the case of emergency.
   
  Date of Application: