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Click here for 2011 registration form 

 

Please fill out the form below carefully. When you press submit, this form will be sent to our administration office.

Alternatively, you can CLICK HERE to download a PDF with this years form and bring/send in to our office.

 

Note: Please use a separate form for each child.

Camper/Parent Information
Name
  First
Middle Last  
Address
  Street
City State
Zip
Date of Birth
   
Contact Info
  Phone
Email
 
Schools
  School
Hebrew 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 Info
  Name
Phone Relationship  
Pediatrician
  Name
Phone    

Email

     
           
Select Child's Age Group
Age 2
Ages 3-4  
Ages 4-5
Ages 6-9  
 
 
Please indicate number of weeks your child will attend camp:
 

  week 1:  June 27- July 1   week 2: July 5-8  week 3: July 11-15

  week 4: July 18-22   week 5 July 25-29

   

 Complete Session: June 27-July 29

 

IMPORTANT
All forms must be completed and submitted before your child begins camp.
I will be paying by: Check Mastercard Visa
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:

 

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Camp Gan Israel 2222 Ventura Blvd Camarillo, CA 93010-1120 805-383-9070
A branch of the world's largest Jewish Camping network, Camp Gan Israel International

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