We are currently accepting applications for Summer 2021. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, feel free to call our director Nechoma Goldman at 405-413-6091 or email [email protected]

Please note that one registration form per child is needed. If you are applying for more than one child, you may leave out the "Parent Information" section.

Child Profile
 
Last Name
First Name
Hebrew Name
Age
DOB

 

Parent Information
 
Father's Name
Father's Occupation
Address
City/Zip
Father's Cell
Father's Work Phone
Father's Email
   
Mother's Name
Mother's Occupation
Address
City/Zip
Mother's Cell
Mother's Work Phone
Mother's Email
   

 

Emergency Information - Other than Parent
 
Emergency Contact 1 
Phone
Emergency Contact 2
Phone
Pick-Up Person 1
Pick-Up Person 2
Doctor's Name
Doctor's Phone Number
Medical Insurance Company
Policy Number
CONFIDENTIAL: Does your child have any allergies, medical conditions or disabilities that we should be aware of? If yes, please describe them and indicate special precautions or care needed.


 

 

Camp Information

Full Session June 28 - July 16 |  Week 1 June 28 - July 2 | Week 2 July 5 - July 9 | Week 3 July 12 - July 16 

  Copy of Copy of CGI Pricing.png

 
Specify Which Programs you are applying for:

 

Hot kosher lunch and snack provided

T-Shirt (Required) Child Size S M L XL $10
Additional T-Shirt Child Size S M L XL $10

How many T-Shirts? What size?

Be a summer sponsor! Send a child to Camp Gan Israel

Full Session $620   Single Session $250

 

Registration / Payment
 
CC Type
Card Number
Billing Address
City, State, Zip     
CVV
Exp Date
Total Registration charges:

Your card will not be charged at this time, CGI tuition is paid through TADS.  Look for an email from them to arrive soon.

 

Additional Information 
 

You must provide the following in order for your child to attend Camp Gan Israel:

  • Up to date immunization records
  • Photo ID of anyone picking up children
  • Copy of health insurance card

Parent Consent

I will install WhatsApp on my phone to receive communications from the camp director.

I will register with TADS (tuition management service) and follow all of their policies and guidelines. 

I will bring my child on time and pick up on time.

In the event of a medical emergency I authorize any adult acting on behalf of CGI to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. 

I will carefully read the Parent Handbook and return the signed signature page.

I will carefully read and return a signed Assumption of Risk, Release and Waiver of Liability Relating to Coronavirus/COVID-19. 


I give permission for my child to participate in all activities and join in camp trips on and beyond camp properties.

I allow my child to be photographed while participating in CGI activities and agree that these pictures may be used for marketing purposes.
Signature and Date I Accept  
Name:  Initials: Date: 

I have a special talent that I would like to share with Camp Gan Israel. If yes, what talent?  
I would like to volunteer at Camp Gan Israel.