Online Registration

experience the summer of your lifetime

Basic Info

Dates: June 19 – July 14
- Week 1: June 19 – 23
  Week 2: June 26 – June 30
  Week 3: July 3 – 7
  Week 4: July 10 – 14
Registration Required by June 10
Ages: 3-12 (3-14 for girls)
Hours: 9:00AM – 3:00PM
There will be daily swim (unless we have field trips, which is yet to be determined)
Lunch and Snacks will be provided.
Cost:

$240 per week!

Parent Info
Mother's Full Name*
First Last
Mother's Cell Phone Number*
Mother's Work Phone Number
Mother's Email*
Father's Full Name*
First Last
Father's Cell Phone Number*
Father's Work Phone Number
Father's Email*
Home Address
Home Address*
Street Address Address Line 2 City State ZIP Code
Emergency Contact Info
Emergency Contact Name*
First Last
Emergency Contact Phone*
Child Registration
How many children are you registering today?
How did you hear of us?*
- Online
- Mailing
- Friend
Was the maternal grandmother of the camper/s born Jewish?*
- Yes
- No
If you answered "No" to the above question, please explain:
Camper 1
Name*
First Last
Hebrew Name
First
Gender*
- Male
- Female
Birth Date*
MM slash DD slash YYYY
School Name*
Hebrew School Name (if applicable)
Grade Entering*
Allergies*
- Yes
- No
If Yes What?*
Please tell us about any of your child’s eating habits that we should be aware of.
In the event that we will have sandwiches, how many sandwiches does your child prefer:*
- 1
- 2
Sandwich Preference*
- Tuna
- Peanut Butter
- Jelly
- Peanut Butter and Jelly
Please tell us about behavioral or medical issues that we should be aware of:
My child will be attending*
- Week 1: June 19 – 23
- Week 2: June 26 – June 30
- Week 3: July 3 – 7
- Week 4: July 10 – 14
Tee Shirts*
- 0 (still have from last year)
- 1
- 2
Tee Shirt Size*
- Not Ordering (still have from last year)
- Kids XS
- Kids S
- Kids M
- Adult S
- Adult M
- Adult L
Gan Izzy Hat*
- No
- Yes
Gan Izzy Draw String Bag*
- No
- Yes
Camper 2
Name*
First Last
Hebrew Name
First
Gender*
- Male
- Female
Birth Date*
MM slash DD slash YYYY
School Name*
Hebrew School Name (if applicable)
Grade Entering*
Allergies*
- Yes
- No
If Yes What?*
Please tell us about any of your child’s eating habits that we should be aware of.
In the event that we will have sandwiches, how many sandwiches does your child prefer:*
- 1
- 2
Sandwich Preference*
- Tuna
- Peanut Butter
- Jelly
- Peanut Butter and Jelly
Please tell us about behavioral or medical issues that we should be aware of:
My child will be attending*
- Week 1: June 19 – 23
- Week 2: June 26 – June 30
- Week 3: July 3 – 7
- Week 4: July 10 – 14
Tee Shirts*
- 0 (still have from last year)
- 1
- 2
Tee Shirt Size*
- Not Ordering (still have from last year)
- Kids XS
- Kids S
- Kids M
- Adult S
- Adult M
- Adult L
Gan Izzy Hat*
- No
- Yes
Gan Izzy Draw String Bag*
- No
- Yes
Camper 3
Name*
First Last
Hebrew Name
First
Gender*
- Male
- Female
Birth Date*
MM slash DD slash YYYY
School Name*
Hebrew School Name (if applicable)
Grade Entering*
Allergies*
- Yes
- No
If Yes What?*
Please tell us about any of your child’s eating habits that we should be aware of.
In the event that we will have sandwiches, how many sandwiches does your child prefer:*
- 1
- 2
Sandwich Preference*
- Tuna
- Peanut Butter
- Jelly
- Peanut Butter and Jelly
Please tell us about behavioral or medical issues that we should be aware of:
My child will be attending*
- Week 1: June 19 – 23
- Week 2: June 26 – June 30
- Week 3: July 3 – 7
- Week 4: July 10 – 14
Tee Shirts*
- 0 (still have from last year)
- 1
- 2
Tee Shirt Size*
- Not Ordering (still have from last year)
- Kids XS
- Kids S
- Kids M
- Adult S
- Adult M
- Adult L
Gan Izzy Hat*
- No
- Yes
Gan Izzy Draw String Bag*
- No
- Yes
Total Cost
Price*
Coupon
Total
$0.00
Payment
If you are unable to pay in full now, if you have already paid for camp, or if you prefer to pay by check, please text Rabbi Motti at (215) 834-1178 for more info.
What's your Payment Method?
- Credit Card
- Check
Credit Card
Credit Card
Email Receipt To:
Check
Check should be made out to "Chabad of DE" (please write "Camp" in the memo):
Chabad of Delaware
Attn: Rabbi Motti
1811 Silverside Road
Wilmington, DE 19810
Consent
Dismissal of a Camper*
Camp Gan Israel reserves the right to dismiss, at its sole discretion, any camper whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interests of the camp or fellow campers or who violates camp rules and regulations, in which case no refunds will be made.
Medical Care*
In the event of an emergency, serious illness, or accident, Camp Gan Israel has permission to arrange for any necessary first-aid or care by a licensed physician for any child/ren attending camp. Every effort will be made to contact the parent/guardian and emergency contacts first. Should it be necessary for the well being of the camper to utilize outside medical or dental services all expenses involved will be paid for by the parent.

Parents are required to notify CGI in a timely manner of any infectious diseases or infestations acquired by a camper during their participation at camp.
Health Form*
I will mail/email rabbimotti@chabadde.com a health form for my child (will be emailed to parents) before my child starts camp.
Parent Handbook*
I will read the complete Parent Handbook to understand all of the camp requirements and expectations (will be emailed at a later date)
Payment*
The parent who signs this registration form confirms that he/she has full authority to do so, and will be responsible for payment of the camp fees.
Promotional Consent*
I hereby give permission for Camp Gan Izzy to use photograph and video footage of my child for any and all promotional purposes.
Field Trip Permission*
I give my child permission to attend all field trips and swimming trips and receive medical care in the case of emergency.
On-site Activities*
I hereby permit my child to participate in all on-site activities.
Illness*
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.
Required Forms*
I will mail/email rabbimotti@chabadde.com the required forms at least one week before camp (will be emailed at a later date)
Waiving Legal Action*
I, and on behalf of my child, agree not to sue Chabad of Delaware, Camp Gan Izzy of Delaware or any of its employees for any damage, claim or injury that my child may sustain, arising from or relating to any activity or camp experience.
Date of Form*
MM slash DD slash YYYY
Signature*
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Online Registration

experience the summer of your lifetime

Basic Info

Parent Info

Home Address

Emergency Contact Info

Child Registration

Camper 1

Camper 2

Camper 3

Total Cost

Payment

Credit Card

Check

Consent