Camp Register Form

Enter the message as it's shown*

Child 1*

First NameMiddle NameLast Name

Gender*

MaleFemale

Going into Year/Class*

$40 per day includes lunch*

Child 2

First NameMiddle NameLast Name

Gender

MaleFemale

Going into Year/Class

Child 3

First NameMiddle NameLast Name

Gender

MaleFemale

Going into Year/Class

Child 4

First NameMiddle NameLast Name

Gender

MaleFemale

Going into Year/Class

If you have additional children please contact us.

Phone Number*

Area CodePhone Number

Emergency Contact*

First NameLast Name

Phone Number*

Area CodePhone Number

Relationship*

To complete payment:

1) Bank Transfer: BSB 126563 Acc 21844174 (leave REF name &CGI)

2) By credit card call 0426963125

3) Pay on the day when you drop the kids off

Payment

Agreement*

I am signing up my child for camp. I give my child permission to attend all trips and receive medical care in the case of emergency, G-d forbid. I give Gan Israel permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the camp sees fit.

General comments, important medical information and allergies

Camp dates: 16-27 January 2023

1. Child/ren’s Information

2. Parent information

3. Emergency Information

4. Payment Information