Our campers enjoy a wide range of exciting activities and field trips in a warm, safe and vivacious atmosphere that exposes the beauty of our Jewish heritage and provides every child with a wonderful and fulfilling camp experience. CGI has all the benefits of specialty camps – rolled up into one!1. Camper's InformationPlease fill out a separate form for each additional childCamper's Name*First NameMiddle NameLast NameBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGrade Entering in September 2019TKKindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth GradeSixth GradeGender*MaleFemaleCamp T-shirt SizePlease chooseYouth X-SmallYouth SmallYouth MediumYouth LargeAdult Small2. Date SelectionWeek One: June 24 - June 28Full 5-Day Camp Experience3-Day Camp ExperiencePlease enter your Week One 3-Day SelectionAM / PM CareJust AM CareJust PM CareMonday Mac & Cheese LunchTuesday Fish Sticks LunchWednesday Sandwich LunchThursday Hot Dog LunchFriday Pizza LunchFriday ChallahWeek Two: July 1 - July 5Full 4-Day Camp Experience3-Day Camp ExperienceNo camp Thursday, July 4thPlease enter your Week Two 3-Day SelectionAM / PM CareJust AM CareJust PM CareMonday Mac & Cheese LunchTuesday Fish Sticks LunchWednesday Sandwich LunchFriday Pizza LunchFriday ChallahWeek Three: July 8 - July 12Full 5-Day Camp Experience3-Day Camp ExperiencePlease enter your Week Three 3-Day SelectionAM / PM CareJust AM CareJust PM CareMonday Mac & Cheese LunchTuesday Fish Sticks LunchWednesday Sandwich LunchThursday Hot Dog LunchFriday Pizza LunchFriday ChallahWeek Four: July 15 - July 19Full 5-Day Camp Experience3-Day Camp ExperiencePlease enter your Week Four 3-Day SelectionAM / PM CareJust AM CareJust PM CareMonday Mac & Cheese LunchTuesday Fish Sticks LunchWednesday Sandwich LunchThursday Hot Dog LunchFriday Pizza LunchFriday ChallahWeek Five: July 22 - July 26Full 5-Day Camp Experience3-Day Camp ExperiencePlease enter your Week Five 3-Day SelectionAM / PM CareJust AM CareJust PM CareMonday Mac & Cheese LunchTuesday Fish Sticks LunchWednesday Sandwich LunchThursday Hot Dog LunchFriday Pizza LunchFriday ChallahWeek Six: July 29 - August 2Full 5-Day Camp Experience3-Day Camp ExperiencePlease enter your Week Six 3-Day SelectionAM / PM CareJust AM CareJust PM CareMonday Mac & Cheese LunchTuesday Fish Sticks LunchWednesday Sandwich LunchThursday Hot Dog LunchFriday Pizza LunchFriday ChallahWeek Seven: August 5 - August 9Full 5-Day Camp Experience3-Day Camp ExperiencePlease enter your Week Seven 3-Day SelectionAM / PM CareJust AM CareJust PM CareMonday Mac & Cheese LunchTuesday Fish Sticks LunchWednesday Sandwich LunchThursday Sandwich LunchFriday Pizza LunchFriday Challah3. Parent InformationPrimary Phone Number*Area CodePhone NumberAddress*Street AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNagorno-KarabakhNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandTurkish Republic of Northern CyprusNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTransnistria PridnestrovieTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryMother's infoFirst NameLast NameCell PhoneArea CodePhone NumberE-mail*Primary emailFather's infoFirst NameLast NameCell PhoneArea CodePhone NumberE-mailHow did you hear of us?MailerEmailFacebookNewspaper AdInternet SearchAttended PreviouslyOther4. Emergency InformationEmergency Contact*First NameLast NameEmergency Contact Phone Number*Area CodePhone NumberRelationship*Pediatrician & InsuranceFirst NameLast NamePhone NumberArea CodePhone NumberInsurancePolicy #5. Credit Card InformationPlease provide a Credit Card for your camp file. You will not be charged at this time.Payment InformationCredit CardVisaMasterCardAmerican ExpressDiscoverCredit Card TypeCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2019202020212022202320242025202620272028Expiration Year6. A Few Questions:Does your child have any medical issues that we should know about?NoAllergies to FoodAsthmaPhysical LimitationAllergies to MedicinesIs your child taking medications at this time?YesNoIf so, please specifyWhat is your child's favorite activity?6. PermissionsThis Child may Be Picked Up From Camp By:Grandparents, Nannies, Friends...WhatsApp NotificationsYes, I would like to receive notifications as to the latest updates during camp to the primary phone number listed aboveNo, thank youTrip Agreement*I permit my child to participate in all activities of Camp Gan Israel, on site, off site and trips.Medical Agreement 1*I understand that my child may be dismissed during a camp day, due to illness, at the discretion of the camp, and I agree to abide by the director’s decision.Medical Agreement 2*Your son/daughter is below legal age of consent. The law requires that we have your permission if medical service should be needed. Your signature at the end of this form will authorize us to proceed with the care for lesser types of medical problems, which may occur.In Case of Emergency*In the event of an emergency when a parent/guardian is unavailable, I hereby authorize a representative of Camp Gan Israel to make such arrangements as considered necessary for my child to receive medical or hospital care, including transportation. Under such circumstances, I further authorize the physician named above to undertake such care and treatment as considered necessary. In the event such physician is not available, I authorize such care and treatment to be performed by any licensed physician or surgeon.I do not choose the above, I desire the following action to be taken in the event of an emergency:Please adviseThe undersigned agrees to bear all costs as a result of the foregoing.*YesPermission to apply sunscreen*Yes, please re-apply sunscreen as neededNo, please do not apply sunscreen at any time throughout the dayPhoto Agreement*I permit my child’s photo to be used on our Camp Website or e-mail newsletters.I do not permit my child’s photo to be used on our Camp Website or e-mail newsletters.General commentsParent Signature*Should be Empty: Submit This page uses TLS encryption to keep your data secure.