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CGI Sudbury Online Registration Form



 

Gan Israel Summer Day Camp Sudbury - online registration!

Camp Gan Israel Sudbury will run for four days  from June 26th - June 29th.

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

Camp Tuition: $250  
Limited Scholarships Available Contact Office for more info

Note: Please use a separate form for each child.

PLEASE NOTE: To secure a spot for your child, a $50 non-refundable
registration fee is required. This fee also includes a Camp T-shirt & Hat and camp supplies and is applied towards tuition.

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  2017

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 $50 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:
 

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Camp Gan Israel Sudbury 100 Horse Pond Road Sudbury, MA 01776 978-443-0110
A branch of the world's largest Jewish Camping network, Camp Gan Israel International

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