Online Application 5785/2024

  • Please fill out the form below carefully.
  • When you press submit, this form will be sent to the camp office.
  • Camp personnel will contact you by email within one week of receiving
    your registration.
  • Payments can be via Zelle to: 443-280-0340 or Paypal: [email protected]
    $300/Week. $60/Day
  • All campers will need a copy of their Immunization Records,
    Health Inventory Form or Drop-in Daycare Form and an Emergency Form on file before the first day of camp. 
    You can download a copy of these forms by clicking on the above links or by getting a copy from your child's school. Returning campers do not need a new Health Inventory Form. 

Camper/Parent Information

Camper 1 Name
First Middle Last

Male
Female

Date of Birth 

(Optional) 
Hebrew Name & Birthday  
If unknown; please write time of birth and we can calculate it for you! 

School  Hebrew School  
Current Grade 

 

Camper 2 Name 
First  Middle  Last  

Male  
Female  

Date of Birth 

(Optional) 
Hebrew Name & Birthday  
If unknown; please write time of birth and we can calculate it for you! 

School  Hebrew School  
Current Grade 

 

Camper 3 Name 
First  Middle  Last  

Male  
Female  

Date of Birth

(Optional)
Hebrew Name & Birthday
If unknown; please write time of birth and we can calculate it for you!

School  Hebrew School  
Current Grade 

 

Contact Info

Address

Street  City  State  Zip 

Phone Email

 


Mother's Information:

Mother's Name Hebrew Name
Jewish Status 
Work Phone Cell
Occupation Work Address
Work Email  

 

Father's Information:

Father's Name Hebrew Name
Jewish Status 
Work Phone Cell
Occupation Work Address
Work Email

 

Pediatrician

Name Phone

Does your child/ren have any allergies? Yes No 

Please download the Allergy Protocol Form for each child with any Allergies by CLICKING HERE (Right click to open in a new tab)

I give permission to my child to be accompanied by members of the staff of Camp Gan Israel on trips off campus, for field trips or lunch outings during summer camp.

I consent: Print Name:

I hereby give 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 consent: Print Name:

I hereby give consent to the administration of Camp Gan Israel to take and post pictures of my child for camp and publicity purposes.

I consent: Print Name:

Please list anything else you would like to inform Camp Gan Israel about your child (Social/Emotional/Behavioral issues/special needs etc.):

Days Attending Camp:


Please Specify days of attendance

Thank you very much.
Looking forward to a fantastic week!

 
 Registration only complete upon payment of deposit

Payments can be via Zelle to: 443-280-0340 or Paypal: [email protected]
$300/Week. $60/Day