Camp Gan Israel
Registration Form 2010

PLEASE COMPLETE THE ENTIRE FORM
PLEASE USE ONE FORM PER CAMPER

CAMPER INFORMATION

Childs Last Name:     
First Name:  
Childs Full Hebrew Name:(use english lettering)
Age as of June 1st:  D. O. B.
Jewish Birthday: Date  Month
(Don't Know the Jewish Birthday? Just Click Here)
Grade Entering:  
Address:  City:
State:  Zip:  Phone:

PARENT INFORMATION

Mothers Name:
Mothers Full Hebrew Name:
Occupation:
Daytime Phone:  Mobile Phone:
Fathers Name:
Fathers Full Hebrew Name:
Occupation:
Daytime Phone:  Mobile Phone:

EMERGENCY CONTACT INFORMATION
When either parent is not available

Additional Emergency Contact Name:
Full Home Address:
Home Phone:  Work Phone:
Mobile Phone:  Relationship to Child:
Physician or Medical Facility Name:
Policy Number:  Phone:
Full Address:

ADDITIONAL CAMPER INFORMATION

School Child is Now Attending:
Hebrew School:
Previous Camp Attended:
Amount of Years:  
Which Activities Does Your Child Enjoy?
In Which Extracurricular Does Your Child Participate Throughout The Year?
Brieflly Describe Your Childs Personality:
Is There Anything Special That You Would Like Us To Know About Your Child (Allergies, etc.)?
Special Comments:

T-SHIRTS

Click on the Icon to the Right Side of  your Childs T-Shirt Size. Rememeber, T-Shirts Run Small and can Shrink. (Sample Shirts Are Available For Sizing).
Small (6-8)  Medium (10-12)  Large (14-16)  X-Large(18-20)
 Yes, I would like  Additional Shirt(s), each costing $10.00.

PARENTAL CONSENT

I herby permit my child to participate at Camp Gan Israel - on-site, off-ste and trips.
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 directors decision.
I will be sending to the office a registration fee of $100.00 for each child. I understand that the fee is non-refundable.
The parent to sign the registration form represents that he/she has full authority to do so and will be responsible for payment of the camp fee.
(Sign) Name:  Date:

CAMP OFFICE -  731 PRINCETON KINGSTON ROAD PRINCETON, NJ 08540.
 FEEL FREE TO CALL AT 609-252-0124