Registration Form

- Our campers enjoy a wide range of exciting activities and field trips in a warm, safe and vivacious atmosphere that exposes the beauty of our Jewish heritage and provides every child with a wonderful and fulfilling camp experience. CGI has all the benefits of specialty camps – rolled up into one!
1. Child/ren’s Information
Child 1*
First Name Middle Name Last Name
Birth Date*

Month Day Year
Grade entering in September 2024*
Gender*

MaleFemale
Sessions - $300 per week *

Week 1Week 2Week 3Full Summer - $8555% Multi Camper Discount (cannot combine with full summer discount)
Morning Care $40/week Discounts not applied

Week 1Week 2Week 3Week 4
After Care $40/week (Not available Friday Discounts not applied

Week 1Week 2Week 3Week 4
Child 2
First Name Middle Name Last Name
Birth Date

Month Day Year
Grade entering in September 2024
Gender

MaleFemale
Sessions - $300 per week

Week 1Week 2Week 3Full Summer - $8555% Multi Camper Discount (cannot combine with full summer discount)
Morning Care $40/week Discounts not applied

Week 1Week 2Week 3Week 4
Child 3
First Name Middle Name Last Name
Birth Date

Month Day Year
Grade entering in September 2024
Gender

MaleFemale
Sessions - $300 per week

Week 1Week 2Week 3Full Summer - $8555% Multi Camper Discount (cannot combine with full summer discount)
Morning Care $40/week Discounts not applied

Week 1Week 2Week 3Week 4
After Care $40/week (Not available Friday Discounts not applied

Week 1Week 2Week 3Week 4
If you have additional children please contact us.
2. Parent information
Primary Phone Number*

Area Code Phone Number

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Mother's info
First Name Last Name
Cell Phone

Area Code Phone Number
E-mail Primary email
Father's info
First Name Last Name
Cell Phone

Area Code Phone Number
E-mail
How did you hear of us?
3. Emergency Information
Emergency Contact*
First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
Pediatrician & Insurance
First Name Last Name
Phone Number

Area Code Phone Number
Insurance
Policy #
Any Allergies or Medications?*

YesNo
If yes please specify
4. Payment Information
Total

$0.00
*

Charge me a deposit of $150 per child (full payment on July 29)Charge me in full today

Payment

Credit Card Other

Agreement*

I am signing up my child for camp. I give my child permission to attend all trips and receive medical care in the case of emergency, G-d forbid. I give Gan Israel permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the camp sees fit.
General comments
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1. Child/ren’s Information

2. Parent information

3. Emergency Information

4. Payment Information