Camp Gan Israel Registration 2024 Please allow yourself a minimum of 15 minutes to complete your registration. Where did you hear about us?* Please specify the name of your friend that referred you to CGI Number of children* Either use the toggle or put in a number. You can register up to 4 children in one form Name* Child First Name Child Last Name Hebrew & Nickname* First Name Nickname Gender* MaleFemale Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Grade entering* Yes I want to register for Camp Gan Israel* I understand that there is a $50 non-refundable registration fee Child will be registered for:* I understand that there is a $25 security fee per week 1 Week2 Weeks3 Weeks4 Weeks Name 2* Child First Name Child Last Name Hebrew & Nickname 2* First Name Nickname Gender 2* MaleFemale Birth Date 2* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Grade entering 2* Yes, I want to register for Child 2 for Camp Gan Israel* I understand that there is a $50 non-refundable registration fee Child 2 will be registered for:* I understand that there is a $25 security fee per week 1 Week2 Weeks3 Weeks4 Weeks Name 3* Child First Name Child Last Name Hebrew & Nickname 3* First Name Nickname Gender 3* MaleFemale Birth Date 3* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Grade entering 3* Yes, I want to register Child 3 for Camp Gan Israel* I understand that there is a $50 non-refundable registration fee Child 3 will be registered for:* I understand that there is a $25 security fee per week 1 Week2 Weeks3 Weeks4 Weeks Name 4* Child First Name Child Last Name Hebrew & Nickname 4* First Name Nickname Gender 4* MaleFemale Birth Date 4* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Grade entering 4* Yes, I want to register Child 4 for Camp Gan Israel* I understand that there is a $50 non-refundable registration fee Child 4 will be registered for:* I understand that there is a $25 security fee per week 1 Week2 Weeks3 Weeks4 Weeks Parent/Guardian Marital Status* Married Single Divorced Separated Parent 1 Type* Primary Contact Mother Father Guardian Parent 1 (or Guardian) Name* First Name Last Name Parent 1 Email* Primary Email for Form Submission Confirmation Parent 1 Cell Phone* Area Code Phone Number Home Phone Number If different then cell number Area Code Phone Number Parent 1 Occupation* Parent 1 Business Phone In case we can't reach you on cell phone Area Code Phone Number Home Address* Child's primary residence Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Parent 2 Type* Mother Father Guardian Parent 2 (or Guardian) Name* First Name Last Name Parent 2 E-mail* Parent 2 Cell Phone* Area Code Phone Number Parent 2 Home Phone Number If different then cell number Area Code Phone Number Parent 2 Occupation* Parent 2 Business Phone In case we can't reach you on cell number Area Code Phone Number Parent 2 Address If different from parent 1 Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Father's Religion* Jewish by birth Jewish by conversion Not Jewish Mother's Religion* Jewish by birth Jewish by conversion Not Jewish Is child adopted* NoYes Synagogue Affiliation* CGI accepts campers from all synagogues / temples, this will not affect acceptance Are there any social or other challenges we should be aware of?* 1. Child may be picked up from camp by: Name and Relationship 2. Child may be picked up from camp by: Name and Relationship MEDICAL AND EMERGENCY CONTACT INFORMATION Local and different from parent / guardian Emergency Contact Name* First Name Last Name Phone Number* Area Code Phone Number Emergency Contact Address* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Relationship* Family Physician* First Name Last Name Physician Office Number* Area Code Phone Number Medical Insurance Company* Insurance Group Number Primary Insured Policy Number* Child Policy Number* Child 2 Policy Number* Child 3 Policy Number* Child 4 Policy Number* MEDICAL RELEASE I hereby give consent to the administration of Camp Gan Israel to take whatever medical measures they deem necessary, at my expense, for my child in the event of a medical emergency. I understand that, when possible, every effort will be made to contact parent/guardian or emergency contact before Camp Gan Israel will undertake such a decision. Signature of Parent or Guardian* I agree that my initials / signature here are in place of a hand written signature and shall hold the same binding effect Date & Time* Month Day Year at 1 2 3 4 5 6 7 8 9 10 11 12 Hour 00 10 20 30 40 50 Minutes AM PM My child/ren is permitted to be given Children's Tylenol, Motrin or similar should the need arise:* YesNo Is your child/ren allergic to any medications?* NoYes Please specify medical allergies. Is your child/ren allergic to any foods?* NoYes Please specify food allergies. Is your child/ren up to date on all immunizations?* YesNo Does your child/ren have a medical, developmental or emotional condition that camp should be aware of?* YesNo Please specify condition(s).* Camp T-shirts (one included in registration fee). Only select the quantity option if you would like to purchase additional T-shirts. T-Shirt Size* Extra Small Small Medium Large Adult Small Adult Medium Adult Large T-Shirt Size Child 2* Extra Small Small Medium Large Adult Small Adult Medium Adult Large T-Shirt Size Child 3* Extra Small Small Medium Large Adult Small Adult Medium Adult Large T-Shirt Size Child 4* Extra Small Small Medium Large Adult Small Adult Medium Adult Large Optional: Additional CGI Swag I would like to order the following number of additional camp shirts ($10 per each additional shirt) 1 2 3 4 Please indicate size/s* Only write, from the above listed sizes I would like to order the following number of embroidered CGI hats ($10/cap) Child - One size fits all 1 2 3 4 I would like to order the following number of embroidered CGI hats ($10/cap) Adult - One size fits all 1 2 3 4 I would like to order the following number of CGI small backpacks ($10/backpack) Adult - One size fits all 1 2 3 4 I would like to order the following number of CGI Large backpacks ($12/backpack) Adult - One size fits all 1 2 3 4 BACKGROUND AND DEVELOPMENTAL INFORMATION The purpose of securing background and developmental information about your child is to help our camp staff better understand your child. Your child’s care during the day is a responsibility we share. Please complete the following questionnaire. Has your child had another past summer camp experience? If yes, please specify.* Yes, Camp Gan Israel of RaleighNo Has your child 2 had another past summer camp experience? If yes, please specify.* Yes, Camp Gan Israel of RaleighNo Has your child 3 had another past summer camp experience? If yes, please specify.* Yes, Camp Gan Israel of RaleighNo Has your child 4 had another past summer camp experience? If yes, please specify.* Yes, Camp Gan Israel of RaleighNo Please specify previous group experience(s) in which your child has participated.* Please specify previous group experience(s) in which your child 2 has participated.* Please specify previous group experience(s) in which your child 3 has participated.* Please specify previous group experience(s) in which your child 4 has participated.* Favorite Activity: This feedback helps us with scheduling activities / extra curricular events for campers Child 2 Favorite Activity: This feedback helps us with scheduling activities / extra curricular events for campers Child 3 Favorite Activity: This feedback helps us with scheduling activities / extra curricular events for campers Child 4 Favorite Activity: This feedback helps us with scheduling activities / extra curricular events for campers What are your child's particular strengths and talents?* What are your child 2's particular strengths and talents?* What are your child 3's particular strengths and talents?* What are your child 4's particular strengths and talents?* Please answer as accurately as possible - My child is:* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. Please answer as accurately as possible - My child 2 is:* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. Please answer as accurately as possible - My child 3 is:* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. Please answer as accurately as possible - My child 4 is:* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. What other information is important to your child/ren's success? TERMS AND CONDITIONS PARENTAL CONSENT: I hereby give consent for my child to participate in all activities of Camp Gan Israel (CGI) both on and off site, trips, transportation to and from trips etc., unless I advise you otherwise in writing. Limited Guardianship Approval: I herby consent that CGI's directors - Rabbi Menachem M Wilschanski & Mrs Brocha S Wilschanski be granted limited guardianship capabilities with regards to signing waivers on behalf of my child / children for trips specified in this years camp schedule. (I do understand that I may still be asked to fill out waivers, as not all locations accept this consent) PAYMENT AND CANCELLATION: Payment terms are a $50.00 non-refundable deposit per camper to accompany registration. The balance is due by June 10, 2024 and is non-refundable after that date. DISMISSAL OF CAMPER: Parent fully understands and agrees that the Camp reserves the right to dismiss, in its sole discretion, any Camper whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interests of the Camp or fellow campers or who violates camp rules and regulations. In the event of dismissal, tuition will be refunded on a pro-rated basis less the $50.00 registration deposit. IMAGES, ETC.: Permission is hereby given to use in promoting the Camp and in other ventures directly relating to the Camp (i) digital, photographic and video images or likenesses of camper; audio of camper; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by camper or originating from Camp or from a Camp-related activity. INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless JLC - Chabad of Raleigh, Sha'arei Israel, Camp Gan Israel (CGI) and its officers, servants or assignees from any liability concerning our child’s involvement in CGI and further agree that the use of any premises during the CGI camp day is made at the risk of the registrant. I have read and agree to all of the terms and conditions in this Application Form. I am including a non-refundable $50.00 registration deposit per camper along with submission of this form. I further agree to remit the full tuition and any other fees by June 10, 2024 as per the agreed timeline of my choice on this form. Signature of Parent or Guardian* Date & Time* Month Day Year at 1 2 3 4 5 6 7 8 9 10 11 12 Hour 00 10 20 30 40 50 Minutes AM PM Optional Add-ons Programs will be determined based on demand. Please contact me regarding* Please select all that apply Before care (8:00am)After-care (3:30pm-5:00pm)I am not in need of any of the above as of now VOLUNTEERING Volunteering I would like to volunteer during camp activities and trips.I would like to volunteer with transportation.I would like to volunteer in the camp kitchen. GENERAL COMMENTS & FEEDBACK Comments / Feedback: PAYMENT Hot lunch is included with registration Your card will be charged a non-refundable $50 registration fee per camper. Upon acceptance to camp, you will be billed the full tuition amount as per your payment preference chosen below. Weekly/Monthly Registration Sign up for all 4 weeks for $100 off! Please select which weeks your child will be attending:* When selecting all 4 weeks, be sure that is the only box you select. Rising K-4th - Week 1 (July 1) - $370Rising K-4th - Week 2 (July 8)- $370Rising K-4th - Week 3 (July 15) - $370Rising K-4th - Week 4 (July 24) - $370Rising K-4th - All 4 Weeks - $1380 (Savings of $100)Rising 5th - 8th - Week 1 (July 1) - $395Rising 5th - 8th - Week 2 (July 8) - $395Rising 5th - 8th - Week 3 (July 15) - $395Rising 5th - 8th - Week 4 (July 24) - $395Rising 5th - 8th - All 4 Weeks - $1480 (Savings of $100) Please select which weeks your child 2 will be attending (Price reflects 5% sibling discount):* When selecting all 4 weeks, be sure that is the only box you select. Rising K-4th - Week 1 (June 26) - $352Rising K-4th - Week 2 (July 3)- $352Rising K-4th - Week 3 (July 10) - $352Rising K-4th - Week 4 (July 17) - $352Rising K-4th - All 4 Weeks - $1308 (Savings of $100)Rising 5th - 8th - Week 1 (June 26) - $376Rising 5th - 8th - Week 2 (July 3) - $376Rising 5th - 8th - Week 3 (July 10) - $376Rising 5th - 8th - Week 4 (July 17) - $376Rising 5th - 8th - All 4 Weeks - $1404 (Savings of $100) Please select which weeks your child 3 will be attending (Price reflects 5% sibling discount):* When selecting all 4 weeks, be sure that is the only box you select. Rising K-4th - Week 1 (June 26) - $352Rising K-4th - Week 2 (July 3)- $352Rising K-4th - Week 3 (July 10) - $352Rising K-4th - Week 4 (July 17) - $352Rising K-4th - All 4 Weeks - $1308 (Savings of $100)Rising 5th - 8th - Week 1 (June 26) - $376Rising 5th - 8th - Week 2 (July 3) - $376Rising 5th - 8th - Week 3 (July 10) - $376Rising 5th - 8th - Week 4 (July 17) - $376Rising 5th - 8th - All 4 Weeks - $1404 (Savings of $100) Please select which weeks your child 4 will be attending (Price reflects 5% sibling discount):* When selecting all 4 weeks, be sure that is the only box you select. Rising K-4th - Week 1 (June 26) - $352Rising K-4th - Week 2 (July 3)- $352Rising K-4th - Week 3 (July 10) - $352Rising K-4th - Week 4 (July 17) - $352Rising K-4th - All 4 Weeks - $1308 (Savings of $100)Rising 5th - 8th - Week 1 (June 26) - $376Rising 5th - 8th - Week 2 (July 3) - $376Rising 5th - 8th - Week 3 (July 10) - $376Rising 5th - 8th - Week 4 (July 17) - $376Rising 5th - 8th - All 4 Weeks - $1404 (Savings of $100) Optional: Help support CGI All donations are tax deductible! At CGI we are committing to a healthy, fun & safe environment for all children, we do our best to make this program available at affordable rates & keep tuitions to a minimum but this does not cover our full camp budget. If you find yourself in a position to give and help others please consider one or more of these add ons: $36 Sponsor snack for a day$54 Sponsor a child for a day in camp$72 Sponsor camp lunch for a day$180 Sponsor snack for a week$360 Sponsor a child for a week$1200 Sponsor a child for full session Scholarship Scholarships are limited and are dependent on availability. If you are struggling to afford the full tuition please click this checkbox to discuss further options I would like to apply for a scholarship. Please contact me. Total: (Includes Security Fees) $0.00 Payment* Credit Card Check Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 Expiration Year Billing Address Street Address City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Please enter CVV / card security code* Write N/A if choosing check option Please note that there is an additional 3% fee for credit card charge. How would you like to pay?* Please allow a few days for processing any and all payments I would like to pay now in fullI would like to pay in 3 payments - Today, next month and the following month.I would like my payment to split into monthly installments (last installment is before June 10th)I would like to pay only the minimum $50 / child registration fee now. I understand that this is non refundable and is separate to camp tuition. (All payments are due by June 9th) Please note that all applications will go through review upon submission. Please allow a few days before any charges to your card. I double checked my total* Total includes security fees Yes Should be Empty: Submit This page uses TLS encryption to keep your data secure.
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