CAMP GAN ISRAEL REGISTRATION 2025Please 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 PARENTS/GUARDIANS INFORMATION Parent/Guardian Marital Status* MarriedSingleDivorcedSeparated Parent 1 Parent/Guardian 1 Type* Primary Contact MotherFatherGuardian Guardian 1: Please detail relationship between guardian and child/ren* Parent/Guardian 1 Name* First Name Last Name Parent/Guardian 1 Email* Primary email for camp-parent communication Parent/Guardian 1 Cell Phone* Area Code Phone Number Home Phone Number Area Code Phone Number Parent/Guardian 1 Occupation* Parent/Guardian 1 Business Phone For cases of emergency, if we aren unable to reach you on your cell phone. Area Code Phone Number Parent 2 Parent 2 Type* MotherFatherGuardian Guardian 2: Please detail relationship between guardian and child/ren* Parent/Guardian 2 Name* First Name Last Name Parent/Guardian 2 E-mail* Parent/Guardian 2 Cell Phone* Area Code Phone Number Parent/Guardian 2 Occupation* Parent/Guardian 2 Business Phone For cases of emergency, if we aren unable to reach you on your cell phone. Area Code Phone Number Parent/Guardian Home Phone Number Area Code Phone Number Home Address* Child's primary residence Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Parent 2 Address If different from Parent/Guardian 1 or Child's Primary Address Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country FAMILY DETAILS Father's Religion* Jewish by birthJewish by conversionNot Jewish Mother's Religion* Jewish by birthJewish by conversionNot Jewish Family Synagogue Affiliation* Camp Gan Israel accepts campers from all synagogues / temples, this will not affect acceptance Do/es your child/ren attend Hebrew School during the academic year?* YesNo Hebrew School of Attendance* How many children are you registering for Camp Gan Israel* Max 4 children per form CHILD 1 Child 1 Details Full Name* First Name Last Name Hebrew Name Nickname/Preferred Name Gender* MaleFemale Date of Birth* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Is child adopted?* NoYes Child 1 Medical Does you child have any medical or developmental conditions we should be aware of?* YesNo Please specify medical/developmental conditions of note:* Does your child have any social/similar challenges we should be aware of?* YesNo Please specify social/similar challenges of note:* Does your child have any food allergies?* NoYes Please detail food allergies* Does your child have any allergies to medication?* NoYes Please detail allergies to medications* May CGI offer Tylenol/Motrin to child should the need arise?* YesNo Is your child up to date on all immunizations?* YesNo Please clarify* Child 1: Getting to know your child! Does your child have prior summer camp experience?* Yes, Camp Gan Israel of RaleighNo Experience with group and social activities* Strengths & Talents* Swim Experience & Comfort Level* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. Other information important to your child's success Child 1 Registration Details Grade Entering* K12345678 I would like to register my child for:* Week 1 of Camp (June 30-July 4)Week 2 of Camp (July 7-July 11)Week 3 of Camp (July 14-July18Week 4 of Camp (July 21-July 25) T-Shirt Size* 1 complementary camp t-shirt is provided to each camper Extra SmallSmallMediumLargeAdult SmallAdult MediumAdult Large CHILD 2 Child 2 Details Child 2: Full Name* First Name Last Name Child 2: Hebrew Name Child 2: Nickname/Preferred Name Child 2: Gender* MaleFemale Child 2 Date of Birth* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child 2: Is child adopted?* NoYes Child 2 Medical Child 2: Does your child have any medical or developmental conditions we should be aware of?* YesNo Child 2: Please specify medical/developmental conditions of note:* Child 2: Does your child have any social/similar challenges we should be aware of?* YesNo Child 2: Please specify social/similar challenges of note:* Child 2: Does your child have any food allergies?* NoYes Child 2: Please detail food allergies* Child 2: Does your child have any allergies to medication?* NoYes Child 2: Please detail allergies to medications* Child 2: May CGI offer Tylenol/Motrin to child should the need arise?* YesNo Child 2: Is your child up to date on all immunizations?* YesNo Child 2: Please clarify* Child 2: Getting to know your child! Child 2: Does your child have prior summer camp experience?* Yes, Camp Gan Israel of RaleighNo Child 2: Experience with group and social activities* Child 2: Favorite & Preferred Activities Child 2: Swim Experience & Comfort Level* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. Child 2: Other information is important to your child's success Child 2 Registration Details Child 2: Grade Entering* K12345678 Child 2: I would like to register my child for:* Week 1 of Camp (June 30-July 4)Week 2 of Camp (July 7-July 11)Week 3 of Camp (July 14-July18Week 4 of Camp (July 21-July 25) Child 2: T-Shirt Size* 1 complementary camp t-shirt is provided to each camper Extra SmallSmallMediumLargeAdult SmallAdult MediumAdult Large CHILD 3 Child 3 Details Child 3: Full Name* First Name Last Name Child 3: Hebrew Name Child 3: Nickname/Preferred Name Child 3: Gender* MaleFemale Child 3: Date of Birth* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child 3: Is child adopted?* NoYes Child 3 Medical Child 3: Does your child have any medical or developmental conditions we should be aware of?* YesNo Child 3: Please specify medical/developmental conditions of note:* Child 3: Does your child have any social/similar challenges we should be aware of?* YesNo Child 3: Please specify social/similar challenges of note:* Child 3: Does your child have any food allergies?* NoYes Child 3: Please detail food allergies* Child 3: Does your child have any allergies to medication?* NoYes Child 3: Please detail allergies to medications* Child 3: May CGI offer Tylenol/Motrin to child should the need arise?* YesNo Child 3: Is your child up to date on all immunizations?* YesNo Child 3: Please clarify* Child 3: Getting to know your child! Child 3: Does your child have prior summer camp experience?* Yes, Camp Gan Israel of RaleighNo Child 3: Experience with group and social activities* Child 3: Favorite & Preferred Activities Child 3: Swim Experience & Comfort Level* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. Child 3: Other information is important to your child's success Child 3 Registration Details Child 3: Grade Entering* K12345678 Child 3: I would like to register my child for:* Week 1 of Camp (June 30-July 4)Week 2 of Camp (July 7-July 11)Week 3 of Camp (July 14-July18Week 4 of Camp (July 21-July 25) Child 3: T-Shirt Size* 1 complementary camp t-shirt is provided to each camper Extra SmallSmallMediumLargeAdult SmallAdult MediumAdult Large CHILD 4 Child 4 Details Child 4: Full Name* First Name Last Name Child 4: Hebrew Name Child 4: Nickname/Preferred Name Child 4: Gender* MaleFemale Child 4: Date of Birth* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child 4: Is child adopted?* NoYes Child 4 Medical Child 4 Does your child have any medical or developmental conditions we should be aware of?* YesNo Child 4: Please specify medical/developmental conditions of note:* Child 4: Does your child have any social/similar challenges we should be aware of?* YesNo Child 4 Please specify social/similar challenges of note:* Child 4: Does your child have any food allergies?* NoYes Child 4: Please detail food allergies* Child 4: Does your child have any allergies to medication?* NoYes Child 4: Please detail allergies to medications* Child 4: May CGI offer Tylenol/Motrin to child should the need arise?* YesNo Child 4: Is your child up to date on all immunizations?* YesNo Child 4: Please clarify* Child 4: Getting to know your child! Child 4: Does your child have prior summer camp experience?* Yes, Camp Gan Israel of RaleighNo Child 4: Experience with group and social activities* Child 4: Favorite & Preferred Activities Child 4: Swim Experience & Comfort Level* Beginner - Not comfortable in water deeper than 3 ft.Intermediate - Comfortable in water deeper than 3 ft.Advanced - An excellent swimmer. Child 4: Other information is important to your child's success Child 4 Registration Details Child 4 Grade Entering* K12345678 Child 4: I would like to register my child for:* Week 1 of Camp (June 30-July 4)Week 2 of Camp (July 7-July 11)Week 3 of Camp (July 14-July18Week 4 of Camp (July 21-July 25) Child 4: T-Shirt Size* 1 complementary camp t-shirt is provided to each camper Extra SmallSmallMediumLargeAdult SmallAdult MediumAdult Large PICKUP AUTHORIZATION Please specify individuals (other than the parents/guardians) authorized to pick up your child/ren from Camp Gan Israel Authorized Pick Up 1 Name Relationship Authorized Pick Up 2 Name Relationship Authorized Pick Up 3 Name Relationship EMERGENCY CONTACT INFORMATION Emergency Contact should be local, and other than parents/guardians Emergency Contact Name* First Name Last Name Relationship* Phone Number* Area Code Phone Number Emergency Contact Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country MEDICAL INFORMATION Family Physician* First Name Last Name Office Name* Office Phone Number* Area Code Phone Number Preferred Hospital* In the event of an emergency Insurance Provider* Suscriber Name* Suscriber ID* Group Number* Please submit photo of the front of your Insurance Card 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 123456789101112 Hour001020304050 MinutesAMPM PHOTOS & PROMOTIONAL MATERIAL Parental Consent* Disclaimer: We will do our utmost to abide by your decision. Please contact us if there are any concerns. I permit photos/videos of my child/ren to be used and distributed for internal camp purposes (photos to parents, camp newsletter)I permit photos/videos of my child/ren to be used for promotional purposes (camp's website/social media pages/promotional print material)I DO NOT permit to have photos/videos of my children used for either internal or promotional purposes CAMP GAN ISRAEL SWAG (optional) Camp Gan Israel T-Shirts Each camper is provided a complementary camp t-shirt as part of their registration. We're glad to offer the opportunity to purchase additional t-shirts for purchase, at $10/per t-shirt. How many additional t-shirts would you like to purchase? $10/ea. 1st Additional T-Shirt Size Child XSChild SChild MChild LAdult SAdult MAdult LAdult XLAdult XXL 2nd Additional T-Shirt Size Child XSChild SChild MChild LAdult SAdult MAdult LAdult XLAdult XXL 3rd Additional T-Shirt Size Child XSChild SChild MChild LAdult SAdult MAdult LAdult XLAdult XXL 4th Additional T-Shirt Size Child XSChild SChild MChild LAdult SAdult MAdult LAdult XLAdult XXL Embroidered Camp Gan Israel Baseball Cap How many CGI Baseball Caps would you like to purchase? $10/ea. One Size Fits All - Child EARLY/AFTER CARE Early and After Care will be offered according to demand. We will follow up with interested families. Please contact me regarding Early Care (8:00-9:00 AM)After Care (3:30-5:00 PM) PARENT VOLUNTEERS We are grateful to parents wishing to be involved in Camp Gan Israel with our different volunteers opportunities! Please talk to me about Volunteering on camp trips and with activitiesAssisting with transportationCooking in the camp kitchen DISCOUNTS & PROMOTIONS Cong. Sha'arei Israel Members: Platinum, Gold & Silver: Members of Cong. Sha'arei Israel in good standing receive a 10% Membership Discount on their core camp tuition (not including registration fees) Early Bird Special: Register by March 3 and receive a $15 per week, per child, discount on your core tuition! Full Session Discount: Sign up for the full 4 weeks at Camp Gan Israel and receive a $100 discount for each child. Additional Child Discount: Families registering more than one child for Camp Gan Israel are eligible for a 5% discount per child, for each additional child. Referred New Family Discount: If you refer a new family to Camp Gan Israel both you and the referred family will receive a $50 discount on your tuition. REGISTRATION Camp Gan Israel Early Bird Registration Rates: Our Early Bird Discounted Rate is valid through March 3rd. On March 4th, our rates will revert to the original amount. Rising K-4th Grade Early Bird Rate PER CHILD $370 per week (total of 4 weeks of camp) $1,380 for 4 weeks ($100 discount) Rising 5th Grade-8th Grade Early Bird Rate PER CHILD $395 per week (total of 4 weeks of camp) $1,480 for 4 weeks ($100 discount) Camp Gan Israel Registration (following March 3rd) Rising K-4th Grade Rates PER CHILD $385 per week (total of 4 weeks of camp) $1,440 for 4 weeks ($100 discount) Rising 5th Grade-8th Grade Rates PER CHILD $410 per week (total of 4 weeks of camp) $1,540 for 4 weeks ($100 discount) Additional Fees REGISTRATION FEE: A $50.00 non-refundable deposit per camper will be charged upon submission of this form, or otherwise must be brought to our offices within 2 weeks of submission to secure your child's place in Camp Gan Israel. This fee is non-refundable. LATE REGISTRATION FEES: Registrations following June 16 will be subject to an additional $50 registration fee, totaling a $100 registration fee per child. This fee is non-refundable. SECURITY FEE: The safety and security of your child/ren are of utmost importance to us. A police officer from Raleigh PD (or other local precincts) will be present from 9-4 while camp is in session. There is a $20 security fee per child, per week, which will be added to your final balance. Bon Appétit, Camp Gan Israel! NEW THIS YEAR! This year, lunch is included in your tuition and will be happily provided to each camper, each day. There is no additional lunch fee. B'teavon! Bon Appétit SCHOLARSHIPS The generosity of our community enables us to offer scholarships to families in need. Scholarships are, however, limited, and are dependent on availability. If your family is in need of financial assistance with camp tuition, please let us know, and we will follow up with you. Scholarship Request Please contact me to discuss scholarship options for my family SPONSORSHIP OPPORTUNITIES At Camp Gan Israel, we do our utmost to make this program available at affordable rates and keep tuition to a minimum. There are also families in our community in need of financial assistance, even for these amounts. We offer these family scholarships so their children can have a summer that's safe, Jewish and fun! Because of this, tuition rates do not cover our full camp budget, and we rely on the generosity of those in a position to give to help cover our full running costs. If you find yourself in a position to give and help others please consider one or more of the following sponsorship opportunities. All sponsorships are tax deductible $50: Sponsor a snack at camp for a day$77: Sponsor a camper from a family in need for a day$180 Sponsor a camp swiming session$250: Sponsor camp lunch for a day$400 Sponsor a camper for a week$1400 Sponsor a camper for full session PAYMENT The final amount due will be calculated upon submission of this from. After all eligible discounts, promotions and relevant fees are applied, we will send you a final invoice via email. The only charges due at this time are: Registration Fees ($50 per child) Additional Camp Gan Israel Swag (if added) Sponsorship opportunities selected Payment Options Please select your preferred payment option* Please charge my card for the full sum once tuition amount is determinedPlease set up a payment plan of 3 installments over three consecutive monthsPlease set up a payment plan of 4 installments over four consecutive months All payments must be completed by Monday, June 16th Preferred Method of Payment* Note: There is a 3% fee for credit card charges Credit Card Paypal Check / Cash Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearPaypal has been selected. Payment will take place on the next page.Billing Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Total amount due at this time: $0.00 Amount due at this time includes: Registration Fees, additional swag (if added), and sponsorship totals ONLY Credit Card: Your card will be charged within the next 2-3 business days. Cash/Check: Payment must be brought to our offices within 2 weeks of submission to secure your child's place in Camp Gan Israel. Reminder: Your final balance will be determined after your registration form has been submitted, and an invoice will be sent with the final amount due. TERMS & 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 otherwise in writing. LIMITED GUARDIANSHIP APPROVAL: I hereby 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) REFUND POLICY: All balances paid towards camp tuition are fully refundable up to 30 days before camp, (this excludes registration and credit card processing fees). After which 50% is refundable up until the first day of camp. After which, there will be no refunds. DISMISSAL OF CAMPER: Parent fully understands and agrees that the Camp Gan Israel 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 CGI 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. INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless the Jewish Life Center, 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. Signature of Parent or Guardian* Date & Time* Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM GENERAL COMMENTS & FEEDBACK Comments / Feedback: Should be Empty: Submit This page uses TLS encryption to keep your data secure.