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Summer Camp

Registration Is Open For Summer 2023!

Child's Information
First Name
Last Name
Date of Birth
Month
Date
Year
Gender
School Information
First Name
Last Name
Date of Birth
Date
Year
Gender
School Information
Parent/Guardian
First Name
Last Name
Cell Phone
Email Address
Home/Mailing Address
Street Address Line 1
Street Address Line 2
City
State/Province
Postal/Zip Code
Country
Additional Contact (In Case of Emergency)
Emergency Contact Name
First Name
Last Name
Phone Number
Relationship
Medical Information
Insurance Provider
Policy Number
Name of Doctor
Doctor's Phone
Allergies (If yes, please explain)
Does your child take medication regularly? (If yes, please specify)
Does your child have any medical (physical, emotional, or mental) conditions we should be aware of?
Additional medical information
Permissions And Waiver
(Check each box after reading the waiver)
In the event that neither parent nor the emergency person can be contacted, Camp Gan Israel has my permission to render any necessary first aid or to secure care by a physician to my child while attending camp. *
I hereby give permission for my child to be taken off-campus on all outings by Camp Gan Israel for Field trips, hiking or the beach. This completed form may be photocopied for outings. I give permission to Camp Gan Israel to use camp photos of my children in any camp publicity. *
I understand that Gan Israel Day Camp is carrying limited liability insurance protecting the camp premises against physical damage and covering the camp staff against negligence. Nevertheless, I agree to accept complete responsibility for damages caused by my child and for injuries incurred and agree to hold Chabad of Pacific Palisades and Camp Gan Israel and its staff harmless and I hereby release said parties from all liability except in cases of gross negligence. *
Camp Rate:
Optional: 
Additional T-Shirts: $15 per T-Shirt, Lunch: $20/week
Sponsorships
For more information call or text us at 310-666-2302
Wed, November 20 2024 19 Cheshvan 5785