Register Online

Please fill out the form below:

Camper 1 Camper 2 Camper 3
Campers Full Name Campers Full Name
Campers Full Name
Hebrew Name
Hebrew Name
Hebrew Name
Date of Birth
 
Date of Birth
Date of Birth
Gender
 
Gender
Gender
School Attending   School Attending
School Attending
Entering Grade   Entering Grade
Entering Grade
           
General Information
Previous Camps Attended
How did you hear about Camp Gan Israel?
What goals would you like to see your child/ren accomplish during camp?
Briefly describe your child/ren's personality

Child/ren's favorite activities
 

Fees ($100 off additional family member)
Financial assistance may be available to your family. We encourage you to call us to discuss how we can help make camp affordable for you. Your inquiry will be kept confidential. Contact us for more details.  

Full session of boys Day Camp 3 weeks June 27 - July 16 - $675 (or 250 per week)

 Full session of BOYS 3 weeks overnight camp June 27 - July 16 - $1000  (or $360 week)
 Full session of GIRLS overnight camp July 29- August 5 - $650 (or $360 per week)
Camp T-Shirt $15
Child  Small  Medium  Large
Adult  Small  Medium  Large
Parents' Information
Parents' Status Married  Widowed  Divorced  Separated
Home phone
Home Address
City
State
Zip
Father's full name
work phone
cell phone
email
Mother's full name
work phone
cell phone
email 
Comments
         
Emergency Contact Information
Contact 1
Phone
Relationship to child
 
Contact 2
Phone
Relationship to child
 
Family Physician
Phone
   
Are there any medical concerns that your child's counselor should be aware of?
 
Permission
I hereby give permission for my child to participate in all Camp Gan Israel activities and trips
I also hereby consent to the administration of Camp Gan Israel to take whatever medical 
     measures they deem necessary for my child, in the event of a medical emergency
I also authorize Camp Gan Israel to have and use photographs, slides and videos of the person 
     named on this application as needed for educational and public relations programs
Parent/Guardian    Date


Payment Details 

Financial assistance may be available to your family. We encourage you to call us to discuss how we can help make camp affordable for you. Your inquiry will be kept confidential. Contact us for more details.  

Last Name   Total charge amount
First Name   Card Type
Address   Card Number
City   Exp. Date  
State   CVV code  3 digits on back of card
Zip   Comments  
 

 

First-camper incentives is provided by the Russian-speaking Jewish Community of SF Bay Area and EZRA USA. To apply sign up here  https://www.birthright-judaism.org/daycamps

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