CGI Sudbury Online Registration Form

CGI web.jpg 

 

Gan Israel Summer Day Camp Sudbury - online registration!

Camp Gan Israel Sudbury will run for three weeks  from June 25th - July 13th.

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

Camp Tuition: Before April 15th $300 One Session, $580 Two Sessions, $850 Three Sessions /
                        After April 16th $320 One Session, $600 Two Sessions, $875 Three Sessions

Registration Fee         $35 Also Includes Camp T-Shirt & Hat   

Limited Scholarships Available Contact Office for more info

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
  Home Phone
   
Schools
  School
Hebrew School (if applicable)

Entering Grade in Sep  2018 

Child's Mother
  Mother's Name
Work Phone Cell
Mother's Email 
Child's Father
  Father's Name
Work Phone Cell

Father's Email

Emergency Contact Info
  Name
Phone Relationship  
Pediatrician
  Name
Phone    

 

       
           
 
 
 
 
   
How did you hear of Gan Izzy? 
online
mailing 
 friend

 other

 
 
Please indicate number of sessions your child will attend camp:
 



     
IMPORTANT
To secure a spot for your child, a $35 non-refundable registration fee is required per a camper.
 

I will be paying by:  Mastercard Visa   Discover Amex

I will send in a  Check   

in the Amount of              

Card Number   

Expiration Date (mm/yy)   

 Security code (The 3 or 4 digit is located inside the signature box on the back of your card immediately after your c.c. number) 

 
 

I have read the camp brochure and application form and I give my child permission to attend all trips, and receive medical care in the case of emergency.

Please note that before camp begins a Health Form will be required for each child. 

   
  Date of Application: