Online Registration Form | Camp Gan Israel at The Shul

	About Our Camp
	Camp Facility
	Our Staff
	Mission Statement
	Online Registration Form
	Scholarships
	Contact Us

LIMITED SPACING SO REGISTER EARLY!

GET READY FOR THE MOST AWESOME SUMMER OF YOUR LIFE!!!

MANY NEW EXCITING ACTIVITIES AND TRIPS!!!

LEGO ROBOTIC WORKSHOPS!

LION COUNTRY SAFARI!!! WATERPARKS!!! MIAMI SEAQUARIUM!!!

WEEKLY TRIPS TO MASTER SANGS TNT KARATE STUDIO!!!

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

Campers Name			First	Middle	Last
Address			Street & Apt. #	City	State	Zip
Date of Birth
Contact Info			Home Phone	Fathers Email Address Mothers Email Address
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

Select Child's Age Group
	Age 2 & 1/2
	Entering nursery
	Entering Pre-K
	Entering P1A - Kindergarten
	Entering 1st grade
	Entering 2nd grade
	Entering 3rd grade
	Entering 4th grade
	Entering 5th grade
	Entering 6th grade
Please indicate when your child will be attending camp:
	Week 1 - June 21 - June 25 Week 2 - June 28 - July 1 Week 3 - July 5 - July 9 Week 4 - July 12 - July 16 Week 5 - July 19 - July 23 Week 6 - July 26 - July 30 Week 7 - August 2 - August 5 ENTIRE SUMMER (June 21 - August 5)

TUITION
		Entire Summer - $1470		Four Weeks -$840	Weekly - $210
Discounts: 5% off for siblings. Scholarships: Scholarships are available based on financial need. Applications cannot be accepted after June 1st. Deposit: A $100 non-refundable deposit is due with registration per child.
IMPORTANT
•	Camp Tuition is due in full before your child attends camp.
•	Registration & Medical forms must be completed and submitted before your child begins camp.
•	I will be paying by: Check Credit Card
	Credit Card Type: Visa MasterCard Credit Card Number: Expiration date:.
	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.
	Comments

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A branch of the world's largest Jewish Camping network, Camp Gan Israel International