Camp Gan Israel

Online Registration Form

Please fill out the form below, someone will be in touch with you shortly


CAMPER 1 CAMPER 2 CAMPER3
Campers Full Name Campers Full Name
Campers Full Name
Hebrew Name
Hebrew Name
Hebrew Name
Date of Birth
 
Date of Birth
Date of Birth
Gender
 
Gender
Gender

School Attending    

School Attending
School Attending
Entering Grade   Entering Grade
Entering Grade
           
General Information
Previous Camps Attended
How did you hear about Camp Gan Israel?
What goals would you like to see your child/ren accomplish during camp?
Briefly describe your child/ren's personality

Child/ren's favorite activities
 

PRICING

TOTS (18 months - 3yr olds)                                                                                        MINI GAN IZZY (Pre K- Kinder) 

Five Full Days  ...............................$2,150.00
9:00am - 3:45p.m
 (Fri 3:30pm dismissal)

Five Half Days................................$1,650.00
9:00am - 12:00pm
 pick up for Tots 12:30p.m pick up for Mini

Three Full Days..............................$1,705.00                                                                     9:00am - 3:45 pm (Fri 3:30pm dismissal)

Three Half Days................................$1,205.00                                                                  9:00am - 12:00pm pick up for Tots 12:30p.m pick up for Mini

Available on a weekly basis for $360 per week. A non- refundable Pre-registration deposit of $250 is required to ensure your child's spot.
*Dismissal will be at 3:30pm on Fridays for all divisions

JUNIOR DIVISION (1st-3rd graders)

     Monday - Friday.............................$2,325.00 
            9:00am - 3:45pm (Fri 3:30pm dismissal)
SENIOR DIVISION (4th -7th graders)
Monday - Friday................................$2,495.00 
    9:00am - 3:45pm (Fri 3:30pm dismissal)

TRANSPORTION                                                                                                               Busing door to door .....................$250.00    (please see front desk to arrange)

Bus stops  ................................. $150.00   (please see front desk to arrange)
Extended Care
Children must be dropped off/picked up for extended care.
8:00 - 9:00am...................................$200.00    
4:00 - 5:00 pm
................................. $200.00
Hourly rate AM and or PM $15

Parent's Information
Parent's Status Married  Widowed  Divorced  Separated
Cell phone
Home Address
City
State
Zip
Father's full name
work phone
cell phone
email (IMPORTANT) 
 
Mother's full name
work phone
cell phone
email (IMPORTANT)
Comments
         

Emergency Contact Information

Contact 1
Phone
Relationship to child
 
Contact 2
Phone
Relationship to child
 
Family Physician
Phone
 Allergies
 
Are there any medical concerns that your child's counselor should be aware of?
 

Permission
I hereby give permission for my child to participate in all Camp Gan Israel activities and trips
I also hereby consent to the administration of Camp Gan Israel to take whatever medical 
meaures they deem necessary for my child, in the event of a medical emergency
I also authorize Camp Gan Israel to have and use photographs, slides and videos of the
person named on this application as needed for educational and public relations programs
Parent/Gaurdian    Date


Payment Details
Last Name First Name Address
City
State
Zip


Total charge amount Card Type Card Number
Exp. Date
   
CVV code  3 digits on back of card
Comments




Chabad of Northeast Queens Camp Gan Israel
For more information please call 718-279-1457