Registration 2024

This form is currently closed.

If your child's age group says Wait List, DO NOT REGISTER, as that group is currently full. You can add your child to the wait List & we will notify you if there is space.

Please click here to be added to the waitlist.

Group Availability Summer 2024
2 Yrs - Wait List
3 Yrs - Wait List
4 Yrs - Wait List
5 Yrs - Wait List
6 Yrs Wait List
7 Yrs - Wait List
8 Yrs - Wait List
9 Yrs - Wait List
9 -13 Yrs Boys - Wait List
10 - 13 Yrs - Girls Almost Full
1. Parent information
Father's info*

Fathers First Name Fathers Last Name
Cell Phone*

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail*
Mother's info*

Mothers First Name Mothers Last Name
Cell Phone*

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail* Primary email

Home Address*

Home Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

2. Child's Information
Child 1*

First Name Middle Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
Grade Entering August 2024*
School Currently Attending *
Allergies or medical concerns*
*

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Child 2

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Grade Entering August 2024
School Currently Attending
Allergies or medical concerns
Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Child 3

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Grade Entering August 2024
School Currently Attending
Allergies or medical concerns
Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Child 4

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
School Currently Attending
Grade Entering August 2024
Allergies or medical concerns
Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
If you have additional children please add in the comments below
Pre & After Care

8:00 -9:00am3:30 - 5:30pm (3:30pm Friday )Both
Bus Transportation from Hollywood (Ages 5+) $15 per week *

NoYes
Bus Transportation from Chai Tots (Ages 5+) $15 per week *

NoYes
3. Emergency Information
Emergency Contact*

Emergency First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
Pediatrician *

Doctor First Name Last Name
Phone Number

Area Code Phone Number
Insurance*
Policy #*
4. Payment Information
A $150 non-refundable registration & security fee applies for each child to ensure a spot in our summer program. This fee is not applied towards camp tuition.

Your acceptance & Invoice will be emailed to you. The bill needs to be paid in full by May 1st, 2024 to honor the early bird discount.
Number of Children Registering*
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

PAYMENTS*

If payment is not made by the early bird deadline of May 1, you will be charged the full rates. A $35 fee will be charged for all returned checks.
CARPOOL & CAMPER RELEASE*

Morning carpool runs from 8:55am until 9:15 am and afternoon carpool runs from 3:15pm until 3:30pm for the preschool camp and 3:30 – 3:45 for the older camp. If you arrive at any other time, you must escort your child to /from the office or classroom. To release your child to anyone aside from his/her parents, or authorized for pickup, prior arrangements must be made with the Camp office. Proper identification must be shown each time your child is picked up.
TRIPS AND EXCURSIONS*

I hereby give Camp Gan Israel permission to take my child on all outings and trips and to sign any & all permission slips on behalf of my child.
PERSONAL PROPERTY*

Camp Gan Israel is not responsible for any stolen or lost items brought to camp. Please do not send your child with expensive electronics or toys
UNRULY BEHAVIOR*

Any camper who physically or emotionally harms him/herself or others is subject to suspension at the Camps discretion.
PROPERTY DAMAGE *

Any camp property damaged by a child, will be the responsibility of the parents to fix, replace or reimburse.
SICK/MISSED DAYS*

No refunds will be given for any withdrawals and/or incomplete attendance regardless of the reason.
Cancellation policy *

After May 1st - With one week advance notice we will credit 50 percent of the unused tuition payment.
Week Change*

After May 1st - there is a $75 fee per change to switch weeks enrolled in camp
MEDIA*

Camp is hereby granted permission to use any photo or video showing your child/ren involved in camp activities.
EMERGENCIES (G-D FORBID)*

If an emergency arises (G-d forbid) and none of the above numbers can be contacted, I hereby give Camp Gan Israel permission to take whatever measure it feels proper and necessary considering circumstances.
Vaccinations *

I confirm that all children attending camp are up to date with their vaccinations
General comments
A $150 per child registration fee will be charged when you submit this form. This fee is non refundable and will not be deducted from your summer camp tuition total.
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1. Parent information

2. Child's Information

3. Emergency Information

4. Payment Information