Gan Israel Day Camps is a project of Maimonides Educational Center and is licensed by the Nassau County Department of Health. We are inspected by their department at least twice yearly and inspection reports are filed at 200 County Seat Drive, Mineola, NY 11501. Click HERE to read the 'Rights and Responsibilities' of Gan Israel Day Camps as the 'Camp Operator'. *Applications are processed on a 'first come, first served' basis. *Your spot is only confirmed once deposit and full payment is received and you receive a confirmation from our office. Registration $85 Number of Campers Registering:* Camper Information Camper 1 Camper 1: Full Name* First Name Last Name Camper 1: Hebrew Name Camper 1: Nickname Camper 1: Gender* MaleFemale Camper 1: Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Camper 1: Grade Fall 2024:* Infant/Pre-Toddler Toddler Nursery Pre-K Kindergarten First Grade Second Grade Third Grade Camper 1: New/Returning* New CamperReturning Camper Camper 1: Is your child toilet trained? YesNo Age Group* Campers must be toilet trained to register for Jr or Sr Gan. Please Select Mini Gan Division (ages 18 mo-3 yr old, ent. T-N) Junior Gan Division (4 yr old, ent. PreK) Senior Gan Division (5-8 yr old, ent. K-3rd grd) Mini Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Full Summer, 5 Half Day Program Full Summer, 3 Half Day Program Single Week (s), 5 Day Program Single Week (s), 5 Half Day Program Single Week (s), 3 Day Program Single Week (s), 3 Half Day Program Jr Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week (s), 5 Day Program Single Week (s), 3 Day Program Senior Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week, 5 Day Program Single Week, 3 Day Program Mini & Jr Gan, 5 Day Program: Week 1: June 30- July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini & Jr Gan, 3 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini Gan, 5 Half Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini Gan, 3 Half Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Senior Gan, 5 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-16 Senior Gan, 3 Day Program: Week 1: June 30 -July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 1: If attending 3 days/week, please specify which days Camper 1: Number of weeks requiring before/aftercare: Number of hours of before/aftercare for Week 1: $50/hr/week Number of hours of before/aftercare for Week 2: $50/hr/week Number of hours of before/aftercare for Week 3: $50/hr/week Number of hours of before/aftercare for Week 4: $50/hr/week Number of hours of before/aftercare for Week 5: $50/hr/week Number of hours of before/aftercare for Week 6: $50/hr/week Number of hours of before/aftercare for Week 7: $50/hr/week Camper 1: Please specify: Before Care (avail. from 8-9 am)After Care (avail. from 3-5 pm) Camper 1: Please specify which days/times, if needed Camper 1: My child receives support services through EI or CPSE:* YesNo SUPPORT SERVICES Occupational Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Physical Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Speech Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Special Instruction/SEIS 10 months12 monthsN/A Mandate (hours and times per week: Camper 1: Any special concerns / allergies / requests regarding camper? Camper 2 Camper 2: Full Name* First Name Last Name Camper 2: Hebrew Name Camper 2: Nickname Camper 2: Gender* MaleFemale Camper 2: Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Camper 2: Grade Fall 2024 Infant/Pre-Toddler Toddler Nursery Pre-K Kindergarten First Grade Second Grade Third Grade Camper 2: New/Returning* New CamperReturning Camper Camper 2: Is your child toilet trained? YesNo Age Group* Campers must be toilet trained to register for Jr or Sr Gan. Please Select Mini Gan Division (ages 18 mo-3 yr old, ent. T-N) Junior Gan Division (4 yr old, ent. PreK) Senior Gan Division (5-8 yr old, ent. K-3rd grd) Mini Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Full Summer, 5 Half Day Program Full Summer, 3 Half Day Program Single Week (s), 5 Day Program Single Week (s), 5 Half Day Program Single Week (s), 3 Day Program Single Week (s), 3 Half Day Program Jr Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week (s), 5 Day Program Single Week (s), 3 Day Program Mini & Jr Gan, 5 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini & Jr Gan, 3 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28 - Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini Gan, 5 Half Day Program: Week 1: June 30 -July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4- 8Week 7: Aug 11-15 Mini Gan, 3 Half Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Senior Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week, 5 Day Program Single Week, 3 Day Program Senior Gan, 5 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Senior Gan, 3 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28 - Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 2: If attending 3 days/week, please specify which days Camper 2: Number of Weekly Before/After Care Hours $35/hr/week Camper 2: Number of weeks requiring before/aftercare: Number of hours of before/aftercare for Week 1: $50/hr/week Number of hours of before/aftercare for Week 2: $50/hr/week Number of hours of before/aftercare for Week 3: $50/hr/week Number of hours of before/aftercare for Week 4: $50/hr/week Number of hours of before/aftercare for Week 5: $50/hr/week Number of hours of before/aftercare for Week 6: $50/hr/week Number of hours of before/aftercare for Week 7: $50/hr/week Camper 2: Please specify: Before Care (avail. from 8-9 am)After Care (avail. from 3-5 pm) Camper 2: If needed, please specify days here: Camper 2: Please specify which days/times, if needed Camper 2: My child receives support services through EI or CPSE:* YesNo SUPPORT SERVICES Occupational Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Physical Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Speech Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Special Instruction/SEIS 10 months12 monthsN/A Mandate (hours and times per week: Camper 2: Any special concerns / allergies / requests regarding camper? Camper 3 Camper 3: Full Name* First Name Last Name Camper 3: Hebrew Name Camper 3: Nickname Camper 3: Gender* MaleFemale Camper 3: Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Camper 3: Grade Fall 2024 Infant/Pre-Toddler Toddler Nursery Pre-K Kindergarten First Grade Second Grade Third Grade Camper 3: New/Returning* NewReturning Camper 3: Is your child toilet trained? YesNo Age Group:* Campers must be toilet trained to register for Jr or Sr Gan. Mini Gan Division (ages 18 mo-3 yr old, ent. T-N) Junior Gan Division (4 yr old, ent. PreK) Senior Gan Division (5-8 yr old, ent. K-3rd grd) Senior Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week, 5 Day Program Single Week, 3 Day Program Mini Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Full Summer, 5 Half Day Program Full Summer, 3 Half Day Program Single Week (s), 5 Day Program Single Week (s), 5 Half Day Program Single Week (s), 3 Day Program Single Week (s), 3 Half Day Program Jr Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week (s), 5 Day Program Single Week (s), 3 Day Program Mini Gan, 3 Half Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini & Jr Gan, 3 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini Gan, 5 Half Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Mini & Jr Gan, 5 Day Program: Week 1: June 30 - July 3Week 2: July 7-1Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Senior Gan, 3 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Senior Gan, 5 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 3: If attending 3 days/week, please specify which days Camper 3: Number of weeks requiring before/aftercare: Number of hours of before/aftercare for Week 1: $50/hr/week Number of hours of before/aftercare for Week 2: $50/hr/week Number of hours of before/aftercare for Week 3: $50/hr/week Number of hours of before/aftercare for Week 4: $50/hr/week Number of hours of before/aftercare for Week 5: $50/hr/week Number of hours of before/aftercare for Week 6: $50/hr/week Number of hours of before/aftercare for Week 7: $50/hr/week Camper 3: Please Specify Before Care (avail. from 8-9 am)After Care (avail. from 3-5 pm) Camper 3: please specify which days/times, if needed Camper 3: My child receives support services through EI or CPSE:* YesNo SUPPORT SERVICES Occupational Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Physical Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Speech Therapy 10 months12 monthsN/A Mandate (hours and times per week: SUPPORT SERVICES Special Instruction/SEIS 10 months12 monthsN/A Mandate (hours and times per week: Camper 3: Any special concerns / allergies / requests regarding camper? Camper 4 Camper 4 Full Name* First Name Last Name Camper 4: Hebrew Name Camper 4: Nickname Camper 4: Gender* MaleFemale Camper 4: Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Camper 4: Grade Fall 2024* Infant/Pre-Toddler Toddler Nursery Pre-K Kindergarten First Grade Second Grade Third Grade Camper 4: Is your child toilet trained? YesNo Camper 4: New/Returning* New CamperReturning Camper Camper 4: Age Group* Campers must be toilet trained to register for Jr or Sr Gan. Mini Gan Division (ages 18mo-3 yr old, ent. T-N) Junior Gan Division (4 yr old, ent. PreK) Senior Gan Division (5-8 yr old, ent. K-3rd grd) Camper 4: Senior Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week, 5 Day Program Single Week, 3 Day Program Camper 4: Mini Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Full Summer, 5 Half Day Program Full Summer, 3 Half Day Program Single Week (s), 5 Day Program Single Week (s), 5 Half Day Program Single Week (s), 3 Day Program Single Week (s), 3 Half Day Program Camper 4: Jr Gan Sessions* Select Weeks Full Summer, 5 Day Program Full Summer, 3 Day Program Single Week (s), 5 Day Program Single Week (s), 3 Day Program Camper 4: Mini Gan, 3 Half Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 4: Mini & Jr Gan, 3 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 4:Mini Gan, 5 Half Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 4 : Mini & Jr Gan, 5 Day Program: Week 1: June 30 - July 3Week 2: July 7-1Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 4: Senior Gan, 3 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 4: Senior Gan, 5 Day Program: Week 1: June 30 - July 3Week 2: July 7-11Week 3: July 14-18Week 4: July 21-25Week 5: July 28- Aug 1Week 6: Aug 4-8Week 7: Aug 11-15 Camper 4: If attending 3 days/week, please specify which days Camper 4: Number of weeks requiring before/aftercare: Camper 4: Number of hours of before/aftercare for Week 1: $50/hr/week Camper 4: Number of hours of before/aftercare for Week 2: $50/hr/week Camper 4: Number of hours of before/aftercare for Week 3: $50/hr/week Camper 4: Number of hours of before/aftercare for Week 4: $50/hr/week Camper 4: Number of hours of before/aftercare for Week 5: $50/hr/week Camper 4: Number of hours of before/aftercare for Week 6: $50/hr/week Camper 4: Number of hours of before/aftercare for Week 7: $50/hr/week Camper 4: Please Specify Before Care (avail. from 8-9 am)After Care (avail. from 3-5 pm) Camper 4: please specify which days/times, if needed Camper 4: My child receives support services through EI or CPSE:* YesNo Camper 4: SUPPORT SERVICES Occupational Therapy 10 months12 monthsN/A Camper 4: Mandate (hours and times per week: Camper 4: SUPPORT SERVICES Physical Therapy 10 months12 monthsN/A Camper 4: Mandate (hours and times per week: Camper 4: SUPPORT SERVICES Speech Therapy 10 months12 monthsN/A Camper 4: Mandate (hours and times per week: Camper 4: SUPPORT SERVICES Special Instruction/SEIS 10 months12 monthsN/A Camper 4: Mandate (hours and times per week: Camper 4: Any special concerns / allergies / requests regarding camper? Family Information Mother's Name* First Name Last Name Mother's Cell* Area Code Phone Number Mother's Work* Area Code Phone Number Mother's Secondary Number Area Code Phone Number Father's Name* First Name Last Name Father's Cell* Area Code Phone Number Father's Work* Area Code Phone Number Father's Secondary Number Area Code Phone Number Address* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Home Phone Number Area Code Phone Number E-mail* Referred by Additional Comments or Requests Background Information Have there been any conversions/adoptions in the family history? * YesNo If yes, please specify: Are both parents Jewish? * YesNo If no, which parent is Jewish? * MomDad Family Synagogue affiliation (if any): Rights and Responsibilities of Camp Operators Click here to read. * I have read and understood the rights and responsibilities of Gan Israel Day Camps. Terms of Agreement 1. PARENTAL CONSENT: I hereby permit my child to participate in all activities of Camp Gan Israel – on and off site including trips. 2. PAYMENT AND Cancelation: An $85 registration fee (per family) and a $150 deposit (per child) is to accompany this signed enrollment agreement. Your registration fee and deposit are refundable if canceled in writing prior to January 31st, 2025. The final balance is due by May 12, 2025 in order to hold your spot and secure your current rate. There are no refunds for absences, vacations, withdrawals, accidents, or illnesses once the camp season has begun. If your child is absent for more than 7 consecutive days for medical reasons, a tuition refund will be made for each day lost after the 7-day deductible period if you submit a doctor’s note. 3. No child will be allowed to attend camp until a completed medical form and full payment have been received. Camp reserves the right to deny a camper's admission to camp for any reason, including but not limited to camper not being a good fit for camp or missing vaccinations. 4.DISMISSAL OF CAMPER: Parent fully understands and agrees that the Camp reserves the right to dismiss, in its sole discretion including but not limited to any camper whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interests of the Camp or his/her fellow campers or who violates camp rules and regulations. In the event of dismissal, tuition will be refunded on a pro-rated weekly basis minus the $150 deposit. For the benefit of your child, the Director should be made aware of any treatment for emotional, neurological, physical or psychiatric disorders. Gan Israel Day Camps reserves the right to cancel the program without prior notice & parents will be fully refunded for tuition already paid for the time period not serviced. 5.MEDICAL CARE: Should it be necessary for the well being of the camper to use outside medical or dental care, all expenses involved will be paid by the Parent. 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 give permission to the Gan Israel staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. 6.IMAGES, ETC.: Permission is hereby given for Camp to use in promoting the Camp and in other ventures related to the Camp (i) digital, photographic, video, and audio images or likenesses of camper; and (ii) statements, articles, music, art, photographs, audio recordings, films and videos created by Camper or originating from Camp or from a Camp-related activity Disclosure* Checking this box is my signature and confirmation that I have read and agree to the camp's terms and conditions. Payment Information In order to submit your registration, a registration fee of $85 per family plus a $150 deposit per child is required, payable by credit card only. For the remaining balance, you may submit 2 post dated checks (dated 3/12/25 & 5/12/25) or schedule 2 Zelle payments to [email protected] on the 2 processing dates (3/12/25 and 5/12/25) and send us a screenshot of your scheduled zelle payments. If checks/zelle schedule are not received by March 1st, your credit card will be charged for the balance of the camp fees on 3/12/25 & 5/12/25 and a 2.5% fee will be added. Please select your payment method below: Payment Terms* Charge my card the full amount of the camp fees and we will waive the 2.5% fee!Charge my card the $85 registration fee & $150 deposit per child now, and charge the balance to my card in 2 parts on March 12th,2025 & May 12th, 2025. I understand that a 2.5% fee will be added to the balance.Charge my card the $85 registration fee & $150 deposit per child now, and I will send in 2 post dated checks for the balance of the camp fees (dated 3/12/25 & 5/12/25). I understand that my credit card will be charged on 3/12/25 & 5/12/25 if my checks are not submitted to the office by 3/1/25.Charge my card the $85 registration fee & $150 deposit per child now, and I will schedule 2 zelle payments to [email protected] for the balance of the camp fees for 3/12/25 & 5/12/25. I understand that my credit card will be charged on 3/12/25 & 5/12/25 with a 2.5% additional fee, if a screenshot of my scheduled Zelle payments are not submitted to the office by 3/1/25. 20% off per child* will be applied after the form is submitted. Yes, please apply a $300 discount per child. (Discount will be applied after submission.) Please note: Discount will be taken off after registration is submitted and is not reflected on the current total. Total $0.00 I would like to pay today:Full amount$235.00 minimum$ Yes, I'd like to donate the cost of processing this transaction by adding 2.5% Payment* Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 Expiration Year Billing Address Street Address City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Notes: Submit Should be Empty: This page uses TLS encryption to keep your data secure.