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Register Online

$75 non-refundable registration fee per camper due with registration. The registration fee will be applied toward the total camp tuition.
Click here for dates and rates.
FIRST WEEK SPECIAL! JUST $25 FOR THE FIRST WEEK! Use promo code '25CAMPER'.* Thanks to Drs. Allan and Lora Alexander for generously underwriting this grant.
Limited availability, first come first serve basis. We will send out an acceptance letter and invoice shortly after we receive your registration.
Family Information
Family Name*

Address*

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

Phone Number*
Area CodePhone Number
Father's E-mail*
Mother's E-mail*
Mother's Name*
First NameLast Name
Mother's Hebrew Name*
Mother's Work Phone Number*
Area CodePhone Number
Mother's Cell Phone Number*
Area CodePhone Number
Father's Name*
First NameLast Name
Father's Hebrew Name*
Father's Work Phone Number*
Area CodePhone Number
Father's Cell Phone Number*
Area CodePhone Number
Emergency Contact Person*
First NameLast Name
Emergency Contact Phone Number*
Area CodePhone Number
Relationship*
Emergency Contact Person*
First NameLast Name
Emergency Contact Phone Number*
Area CodePhone Number
Relationship*
Pediatrician Name*
First NameLast Name
Pediatrician Phone Number*
Area CodePhone Number
Who can we thank for referring you?*
Camper Information
Name*
Gender*
Date of Birth*
MonthDayYear
School*
Entering Grade*
Medication*
Allergies*
Health Issues, disabilities or special needs of child:*
I would like to order the following amount of tshirts:$7/each - Must be ordered by June 1.
T-shirt size(A) implies adult sizes
Age group*Please indicate weeks attending below.
Explorers: Grades K - 1Trailblazers: Grades 2 - 4Pioneers: Grades 5 – 7
Explorers/Trailblazers attending:
Full SessionWeek 1Week 2Week 3Week 4
Pioneers attending:
Full SessionWeek 1Week 2Week 3Week 4
I will need the following amount of weeks of before care ($25/week)
I will need the following amount of weeks of after care ($25/week)
►Click here to register additional children. Please first complete and submit this form before beginning the other form.
IMPORTANT
All forms must be completed and submitted before your child begins camp.
Payment Plan*
Please charge me the full amount today.Please charge me the $75 registration fee and I will remit payment with an invoice.I have completed the scholarship form, and have specified the amount I am seeking.
Click here to access the scholarship form.

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

I have read and agree to the terms and conditions . I authorize Camp Gan Israel, to have my child treated in case of emergency by a physician in the manner such person deems necessary. I further give permission for my child to attend and be transported on camp trips.

Please type your name here:*
Date of Application:*
Discount Code:Discounts will be applied before your card is charged.
Should be Empty:

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Family Information

Camper Information

IMPORTANT