Camp Gan Israel Registration Form 2025

EARLY BIRD REGISTRATION FORM FOR SUMMER 2025

(Click Here to go to the home page of Camp Gan Israel)

REGISTER TODAY TO SAVE YOUR SPOT:

Based on 3 Tier Pricing:

Tier 3 $550 per week: Elective options can be added individually
Tier 2 $650 per week: Includes most elective options
Tier 1 $850 per week: Includes all elective options

Additional Savings Off The Total:
*Save five percent with the siblings discount

*Special Referral Discount - Save $500 for each child that you refer
(savings are prorated by the week)
Child 1
Full Name
First Name Last Name
Birth Date

Month Day Year
School Info
Grade Entering School Attending
Any Allergies

NoYes - list all allergies below
Allergies
T-Shirt Size
Camp runs for 8 weeks from Monday, June 29th - Wednesday, August 19

Last week is partial week and counted as one full week for pricing
(based on 3 tier pricing for the amount of days in those weeks)
Dates Attending Check all that apply

Week 1: 6/29 - 7/3Week 2: 7/6 - 7/10Week 3: 7/13 - 7/17Week 4: 7/20 - 7/24Week 5: 7/27 - 7/31Week 6: 8/3 - 8/7Week 7: 8/10 -8/14Week 8: 8/17 - 8/19
Additional Electives Options

Door to door busing $125.00/weekSwimming Lessons $40/weekLunch $ 40/weekHorseback Riding Lessons $65/week
Please click on the electives you would like to choose: (electives can be added or changed at anytime)
Tier 1 won't be charged additional for electives chosen
Tier 2 won't be charged additional for electives chosen (Bussing will be $75 instead of $125)
Tier 3 will be charged the prices listed
Choose Your Tier / Tuition Rate

Tier 3: $550.00 weeklyTier 2: $650.00 weeklyTier 1: $750.00 weekly
Child 2
Full Name
First Name Last Name
Birth Date

Month Day Year
School Info
Grade Entering School Attending
Any Allergies

NoYes - list all allergies below
Allergies
T-Shirt Size
Dates Attending Check all that apply

Week 1: 6/30 - 7/4Week 2: 7/ 7- 7/11Week 3: 7/14- 7/18Week 4: 7/21 - 7/25Week 5: 7/28 - 8/1Week 6: 8/4 - 8/8Week 7: 8/11- 8/15Week 8: 8/18 - 8/20
Additional Electives Options

Door to door busing $125.00/weekSwimming Lessons $40/weekLunch $ 40/weekHorseback Riding Lessons $65/week
Please click on the electives you would like to choose: (electives can be added or changed at anytime)
Tier 1 won't be charged additional for electives chosen
Tier 2 won't be charged additional for electives chosen (Bussing will be $75 instead of $125)
Tier 3 will be charged the prices listed
Choose Your Tier / Tuition Rate

Tier 3: $550.00 weeklyTier 2: $650.00 weeklyTier 1: $750.00 weekly
Child 3
Full Name
First Name Last Name
Birth Date

Month Day Year
School Info
Grade Entering School Attending
Any Allergies

NoYes - list all allergies below
Allergies
T-Shirt Size
Dates Attending Check all that apply

Week 1: 6/30 - 7/4Week 2: 7/7 - 7/11Week 3: 7/14 - 7/18Week 4: 7/21 - 7/25Week 5: 7/28 - 8/1Week 6: 8/4 - 8/8Week 7: 8/11 - 8/15Week 8:/18 - 8/20
Additional Electives Options

Door to door busing $125.00/weekSwimming Lessons $40/weekLunch $ 40/weekHorseback Riding Lessons $65/week
Please click on the electives you would like to choose: (electives can be added or changed at anytime)
Tier 1 won't be charged additional for electives chosen
Tier 2 won't be charged additional for electives chosen (Bussing will be $75 instead of $125)
Tier 3 will be charged the prices listed
Choose Your Tier / Tuition Rate

Tier 3: $550.00 weeklyTier 2: $650.00 weeklyTier 1: $750.00 weekly
Mother's Info
Full Name
First Name Last Name
Cell Number

Area Code Phone Number
Mother Jewish

YesNoConverted OrthodoxConverted ConservativeConverted Reform
Home Number

Area Code Phone Number
E-mail

Address

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

Father's info
Full Name
First Name Last Name
Father Jewish

YesNoConverted OrthodoxConverted ConservativeConverted Reform
Cell Number

Area Code Phone Number
Home Number

Area Code Phone Number
E-mail

Address

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

Emergency Contact Information
Please provide 2 emergency contacts besides parents
Contact 1
First Name Last Name
Relationship to Child
Cell Number

Area Code Phone Number
E-mail
Contact 2
First Name Last Name
Relationship to Child
Cell Number

Area Code Phone Number
E-mail
Special Notes
First Year Camper(s) at CGI

NoYes
If you were referred to Camp Gan Israel by a friend, please type here their first and last name or business name
Promo Code - Optional
TUITION PRICE:
REGISTER TODAY
REGULAR TUITION RATE:
$550 per week

*Save five percent with the siblings discount

SPECIAL REFERRAL SAVINGS
SAVE $500 FOR EACH FAMILY REFERRED
Amount to charge: Minimum Deposit per child $600
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.
By entering your email you are accepting the terms above*
Payment Options:
If you have any questions, please call us at 631-213-7502. Thank you.

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