AT CAMP GAN ISRAEL

Teen Camp

Boys and Girls Grades 7-10
Camp Hours
9:30 AM - 5:30 PM Monday-Thursday
Summer 2019 Dates:July 15 - August 15

Prices
600 per week (includes meals and snack).
Breakfast, Lunch, & Dinner - is included
Click HERE for more info
Click HERE for last years photos
Click HERE for the 2019 Trip Calendar
TEEN Camp Registration
For full list of trips check HERE
Child 1
Full Name*
First NameLast Name
Birth Date*
MonthDayYear
School Info*
Grade EnteringSchool Attending
T-Shirt Size*
Any Allergies?*
NoYes - list all allergies below
Allergies
Dates Attending Check all that apply (at least 2 weeks)*
Week 1: 7/15 - 7/18Week 2: 7/22 - 7/25Week 3: 7/29 - 8/1Week 4: 8/5 - 8/8Week 5: 8/12 - 8/15
Busing $50/week
YesNo
Weeks need bussing
Dont need bussingWeek 1: 7/15 - 7/18Week 2: 7/22 - 7/25Week 3: 7/29 - 8/1Week 4: 8/5 - 8/8Week 5: 8/12 - 8/15
Child 2
Full Name
First NameLast Name
Birth Date
MonthDayYear
School Info
Grade EnteringSchool Attending
T-Shirt Size
Any Allergies?
NoYes - list all allergies below
Allergies
Dates Attending Check all that apply (at least 2 weeks)
Week 1: 7/15 - 7/18Week 2: 7/22 - 7/25Week 3: 7/29 - 8/1Week 4: 8/5 - 8/8Week 5: 8/12 - 8/15
Busing $50/week
YesNo
Weeks need bussing
Don't need bussingWeek 1: 7/15 - 7/18Week 2: 7/22 - 7/25Week 3: 7/29 - 8/1Week 4: 8/5 - 8/8Week 5: 8/12 - 8/15
Parents Information

Address*

Home Number*
Area CodePhone Number
Mother's Info
Name*
Cell Number*
Area CodePhone Number
Email*
Father's Info
Name*
Cell Number*
Area CodePhone Number
E-mail*
Emergency Contact Information
Please provide 2 emergency contacts besides parents
Contact 1*
First NameLast Name
Relationship to Child*
Cell Number*
Area CodePhone Number
E-mail*
Contact 2*
First NameLast Name
Relationship to Child*
Cell Number*
Area CodePhone Number
E-mail*
Total
$0.00
NO CANCELLATIONS | NO REFUNDS
Terms and Conditions*
I, the undersigned agree, understand and authorize the amount shown above to be charged to my credit card for the items shown on the referenced order. I understand these charges will appear on my credit card statement under my name and I accept full financial responsibility for payment of this order.I agree payments are non-refundable and services / merchandise have been rendered / delivered to my satisfaction.
By entering your email you are accepting the terms above*

Payment*

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Comments
Your registration will only be confirmed once we get a copy of your child's Medical Form and once payment is settled. Please email the form to Camp@ChabadGN.com
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TEEN Camp Registration