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Register

Register

Summer Session 2017 | June 29 - July 31   

Detailed Registration Letter: Click here.
Required NYC Health Form: Click here.

MINI CAMP GAN ISRAEL 2017
Click here to download registration form.

JUNIOR CAMP GAN ISRAEL 2017
Click here to download registration form.

REGISTER ONLINE
Please fill out the form below.

Mini-Gan is for children aged 3-4 years old. Children must turn 3 on or before October 31, 2017.
Children who turn 5 on or before October 31, 2017 will join the Junior Gan Izzy division.

Camper 1 Camper 2 Camper 3
Mini Gan Junior Gan Mini Gan Junior Gan Mini Gan Junior Gan
Camper's Full Name Camper's Full Name
Camper's Full Name
Hebrew Name
Hebrew Name
Hebrew Name
Age
Age
Age
Date of Birth
Date of Birth
Date of Birth
Born after Sunset
Yes No
Born after Sunset
Yes No
Born after Sunset
Yes No
Jewish Birth Date
Jewish Birth Date
Jewish Birth Date
Gender
Gender
Gender
School Attending School Attending
School Attending
Hebrew School Attending
Hebrew School Attending
Hebrew School Attending
Entering Grade Entering Grade
Entering Grade
           
Additional Camper Information
Camper 1 Camper 2 Camper 3
In which extracurricular activities does your child participate throughout the year?
In which extracurricular activities does your child participate throughout the year?
In which extracurricular activities does your child participate throughout the year?
Does your child have any known allergies?
Does your child have any known allergies?
Does your child have any known allergies?
Is your child receiving any services? If yes, please specify (i.e. physical therapy, etc.)
Is your child receiving any services? If yes, please specify (i.e. physical therapy, etc.)
Is your child receiving any services? If yes, please specify (i.e. physical therapy, etc.)
Briefly describe your child's personality
Briefly describe your child's personality
Briefly describe your child's personality
What goals would you like to see your child accomplish during camp?
What goals would you like to see your child accomplish during camp?
What goals would you like to see your child accomplish during camp?
Child's favorite activities
Child's favorite activities
Child's favorite activities
Group placement: I would like my child placed with (must be entering same grade) - up to 4 names
Group placement: I would like my child placed with (must be entering same grade) - up to 4 names
Group placement: I would like my child placed with (must be entering same grade) - up to 4 names
Previous Camps Attended
How did you hear about Camp Gan Israel?

Parents' Information
Parents' Status Married Widowed Divorced Separated
Home phone
Home Address
City
State
Zip
Father
First name
Last name
Hebrew name
Occupation
cell phone
work phone
email
Mother
First name
Last name
Hebrew name

Is the natural mother of the child Jewish?
Yes No

Occupation
cell phone
work phone
email
Comments
         

Emergency Contact Information

Contact 1
Phone
Relationship to child
Are there any medical concerns that your child/ren's counselor/s should be aware of?

Contact 2
Phone
Relationship to child
Family Physician
Phone
Address

Swimming
Please describe your child’s swimming ability by selecting from the following choices:
Camper 1 Camper 2 Camper 3
Is scared of the water Is scared of the water Is scared of the water
Can submerge face in water Can submerge face in water Can submerge face in water
Can go underwater Can go underwater Can go underwater
Can float without a flotation device Can float without a flotation device Can float without a flotation device
Can tread water Can tread water Can tread water
Can swim in the deep end Can swim in the deep end Can swim in the deep end
Can dive from a diving board Can dive from a diving board Can dive from a diving board
Can do the following swim strokes:
Front Crawl
Back Stroke
Breast Stroke
Side Stroke
Can do the following swim strokes:
Front Crawl
Back Stroke
Breast Stroke
Side Stroke
Can do the following swim strokes:
Front Crawl
Back Stroke
Breast Stroke
Side Stroke
Beginner Beginner Beginner

Tee Shirts
Please note, for the safety of your child, we require that all campers & staff wear a Camp Gan Israel t-shirt each day. While on field trips, camp shirts distinguish our campers and staff from other visitors. While at camp, it allows our staff to immediately recognize any visiting children, parents, etc., as well as enable campers to recognize staff members. Registration includes two t-shirts per camper. Used T-shirts of various sizes may also be available at the Camp Office (limit 2 per camper). Call to arrange a time to check for your size/pick them up.
Please circle your child’s t-shirt size. T-shirts can shrink and tend to run small. When in doubt, order the next size. (Sample shirts are available to try on for sizing.)
Camper 1 Camper 2 Camper 3
X-Small (4T)
Small (6 – 8)
Medium (10 – 12)
Large (14-16)
Small-Adult
X-Small (4T)
Small (6 – 8)
Medium (10 – 12)
Large (14-16)
Small-Adult
X-Small (4T)
Small (6 – 8)
Medium (10 – 12)
Large (14-16)
Small-Adult
If you would like additional t-shirts at a cost of $12.00 per short sleeved shirt, please indicate below:

Yes, I would like extra t-shirts. Enclosed please find $

Yes, I would like extra t-shirts. Enclosed please find $ Yes, I would like extra t-shirts. Enclosed please find $

Fees

Camp tuition is due in full by May 5, 2017


Camper 1 Camper 2 Camper 3

Mini Gan
Tuition: $2850
$100 off for registration before February 28.

Must include $600.00 minimum non-refundable deposit to confirm registration.

$600.00 deposit towards camp tuition of $2750. $600.00 deposit towards $2750 $600.00 deposit towards $2750
$ towards $2750 & $400.00 Extended Day $ towards $2750 & $400.00 Extended Day $ towards total early bird registration fee of $2750 & $400.00 Extended Day
Junior Gan

Tuition fee: $2950.

$100 off for registration before February 28

Camp tuition is due in full by May 5, 2017


Must include $600.00 minimum non-refundable deposit to confirm registration.

     
$600.00 deposit towards $2850. $600.00 deposit towards $2850 $600.00 deposit towards $2850
$ towards $2850 $ towards $2850 $ towards $2850
 

CAMP BUNK LISTS AND PHOTOS
Yes! No! You may include my child’s name, email & phone number on the bunk list made available to parents in the first newspaper.

Yes! No! You may include my child’s photo to be used on the website, video & any other Camp Gan Israel related publications.


PARENTAL INVOLVEMENT
Yes! I would like to get involved! Bunk mother Camp Committee

Permission

I hereby permit my child to participate in all activities at Camp Gan Israel – on site, off-site and trips. I release Camp Gan Israel of Riverdale and individuals from liability in case of accident during activities related to Camp Gan Israel of Riverdale, as long as normal safety procedures have been taken. I understand that my child may be dismissed during a camp day, due to illness, at the discretion of the camp, and I agree to abide by the director’s decision. I am enclosing a minimum registration fee of $600.00 for each child. I understand that the fee is non-refundable.

I have read and understand completely that my child will be swimming at the Whitehall Club swimming pool located at 3333 Henry Hudson Pkwy. I give my child permission to participate in swimming as scheduled by Camp Gan Israel of Riverdale.

The parent who signs the registration form represents that he/she has full authority to do so and will be responsible for payment of the camp fee.

Parent/Guardian Date

SPONSOR A CAMPER
Yes! I would like to enable another child to enjoy a summer at Camp Gan Israel.
I am enclosing: $550.00 for one week $1,550.00 for three weeks $2,775.00 full summer
$ towards tuition for another camper.

Payment Details

Please note that any payment arrangement must be made prior to handing in this form and must be approved by the Camp Director. Please ensure to also send back and front copies of your child/ren's medical card and medical forms.

I will send in checks made payable to Chabad Gan Israel of Riverdale
Please charge my card below
Last Name First Name Address
City
State
Zip
Total charge amount Card Type Card Number
Exp. Date
  Comments
Chabad of Riverdale Camp Gan Israel
For more information please call 718-549-1100 Ext. 10

This activity is not sponsored or endorsed by the New York City Department of Education or the City of New York.

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