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Registration form:

Please fill out the form below carefully.

When you press submit, this form will be sent to our administration office.

Note: Please use a separate form for each child.

Camper/Parent Information
Camper Name
  First Middle Last Hebrew

Gender

 

Male Female

     
Address
  Street

City

State Zip
Date of Birth
     
Contact Info
  Home Phone
Email
Cell Phone
Schools
  School Entering Grade:
Child's Mother
  Mother's Name
Hebrew Name Work Phone Cell
Child's Father
  Father's Name
Hebrew Name Work Phone Cell

Emergency Contact 1

  Name Phone Relationship  
Emergency Contact 2
  Name Phone Relationship  
Pediatrician
  Name

Phone

Address

 

Transportation

 

Will you be using the bus transportation to camp?

 
 
Is Mother Jewish? Enter Yes No
Is Father Jewish? Enter Yes No
Please indicate which sessions your child will be attending camp:

Week 5 July-July 8 Week 2 July 11-15 Week 3 July 18-22

Week 4 July 25-29 Week 5 August 1-5Week 6 August 8-12 Week 7 August 15-18

   

How did you hear about Gan Israel Chamah Day Camp? Detail

 
IMPORTANT
All forms must be completed and submitted before your child begins camp. This includes the Physical Examination Form, Food Form, and any other forms that are posted.
I will be paying by: Check Credit card Other
I have read the camp brochure and application form and agree to the terms stated. I give my child permission to attend all trips, and receive medical care in the case of emergency
   
  Date of Application:

 

Camp Gan Israel Chamah Photo Release Agreement:

At Camp Gan Israel Chamah, we take photos of our fun activities in camp throughout the summer. We upload these photos on our website to keep parents updated and for others interested in our camp to see them. We also use some of the photos for promotional purposes such as brochures, flyers, website, proposals, etc. By completing this registration form you agree that Camp Gan Israel Chamah has permission to use photos/video that may have your child/children in them for purposes stated above.

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Brooklyn Jewish Camp - Gan Israel Chama - 60 West End Avenue (Manhattan Beach), Brooklyn NY 11235 - Tel. 347-495-3918
A branch of the world's largest Jewish Camping network, Camp Gan Israel International

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