Registration 2026

Camper Information
Full Name*
First Name Last Name
Birth Date

Month Day Year
Grade*
Allergy Info:
T-Shirt Size

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Choose your child's camp duration:

1 Week2 Weeks3 WeeksChoose Individual Days
Which week?

Session 1: June 22 - 26Session 2: June 29 - July 3Session 3: July 6 - 10
Which weeks?

Session 1: June 22 - 26Session 2: June 29 - July 3Session 3: July 6 - 10
Session 1 June 22 - 26

MondayTuesdayWednesdayThursdayFriday
Session 2 June 29 - July 3

MondayTuesdayWednesdayThursdayFriday
Session 3 July 6 -10

MondayTuesdayWednesdayThursdayFriday
Register Additional Child?

YesNo
Full Name*
First Name Last Name
Birth Date

Month Day Year
Grade*
Allergy Info
T-Shirt Size

X-SmallSmallMediumLargeX-Large
Choose your child's camp duration:

1 Week2 Weeks3 WeeksChoose Individual Days
Which week?

Session 1: June 22 - 26Session 2: June 29 - July 3Session 3: July 6 - 10
Which weeks?

Session 1: June 22 - 26Session 2: June 29 - July 3Session 3: July 6 - 10
Session 1 June 22 - 26

MondayTuesdayWednesdayThursdayFriday
Session 2 June 29 - July 3

MondayTuesdayWednesdayThursdayFriday
Session 3 July 6 -10

MondayTuesdayWednesdayThursdayFriday
Register Additional Child?

YesNo
Full Name*
First Name Last Name
Birth Date

Month Day Year
Grade*
Allergy Info
T-Shirt Size

X-SmallSmallMediumLargeX-Large
Choose your child's camp duration:

1 Week2 Weeks3 WeeksChoose Individual Days
Which week?

Session 1: June 22 - 26Session 2: June 29 - July 3Session 3: July 6 - 10
Which weeks?

Session 1: June 22 - 26Session 2: June 29 - July 3Session 3: July 6 - 10
Session 1 June 22 - 26

MondayTuesdayWednesdayThursdayFriday
Session 2 June 29 - July 3

MondayTuesdayWednesdayThursdayFriday
Session 3 July 6 -10

MondayTuesdayWednesdayThursdayFriday
Parent Information
Legal Guardian*
First Name Last Name
Phone Number*
E-mail*

Address*

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

Emergency Contacts
2 Contacts Required
Full Name*
First Name Last Name
Phone Number*
Full Name*
First Name Last Name
Phone Number*
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.
Type Initials
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Camper Information

Parent Information

Emergency Contacts

Releases

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