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Online Registration!

For Camp Rates click here

To register, please fill out carefully.  There is a $35 non-refundable registration fee.

You can also register by printing out our Camp Registration PDF and sending along with check. Click here for the Camp Forms Page.

When you press submit, this form will be sent to our administration 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
   
           
Select Child's Age Group
Ages 10-13
Ages 3-5  
Ages 5-9
 
   
 
 
Please indicate the weeks your child will attend camp (N/A For Winter Camp):

 

Week 1       Week 2     Week 3     Week 4
     
IMPORTANT
All forms must be completed and submitted before your child begins camp.
  With the submission of this form I am paying for: Only Regisration Fee  Partial Tuition & Registration Fee  Full Tuition & Registration Fee
I will be paying by: Check Mastercard Visa Amex

Card Number

  Expiration Date
Cardholder
Name
 Total Amount 
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 1190 Highway A1A Satellite Beach, FL 32937 321-777-2770
A branch of the world's largest Jewish Camping network, Camp Gan Israel International

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