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Riverside

Camp Gan Israel

fun forever!

ב"ה

Registration

Mailing Address*

Emergency Contact #1*
First NameLast Name
Phone Number*
Area CodePhone Number
Emergency Contact #2
First NameLast Name
Phone Number
Area CodePhone Number
Allergy Info:Please provide any allergy or other medical information we should be know about:
Payment Information
Camp Fees:
One Week: $219 - Register by May 1st $199
Both Weeks: $419 - Register by May 1st $379
Individual Days: $50 per day - Register by May 1st $45
Discounts: Sibling Children additional 5% discount
Camp Fees:
One Week: $219
Both Weeks: $419
Individual Days: $50 per day
Discounts: Sibling Children additional 5% discount
Select week(s)*
Select Individual Days for week 1
MondayTuesdayWednesdayThursdayFriday
Select Individual Days for week 2
MondayTuesdayWednesdayThursdayFriday
Amount to charge today:*
$
If applicable: Please charge the balance on:
Total
$0.00

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Releases: As the parent(s) or legal guardian of the above child/ren, I authorize any adult acting on behalf of Camp Gan Israel/Chabad of Riverside to transport my child/ren by means of transportation provided. My child/ren is/are allowed to participate in all off campus activities and trips. In the event of an emergency, when I am not available, I authorize a representative of Cam Gan Israel/Chabad of Riverside to make such arrangements as considered necessary, to receive medical or hospital care. I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit Camp Gan Israel/Chabad of Riverside personnel will try, but are not required, to communicate with me/us prior to such treatment.
*
I agree to the terms and conditions above.
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Comments:
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