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Registration for Camp Gan Israel West Bay 

Please fill out the form below carefully. 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 Name
 Hebrew Name
Address
  Street
City State
Zip
Date of Birth
  Day
Month
Year
 
Contact Info
  Home Phone
Email #1
 
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    

Email #2

   Email #3  
           
Select Child's Age Group
Mini Gan Izzi Ages 3-4

Boys Pioneer division. Ages 10-13 (Week 1 & 2)

 

Camp Gan Israel for girls and boys ages 5 - 9

Girls Cooking Camp Ages    10-13 (Available all 3 weeks)

 
 
                                                                    Boys Adventure camp Ages 12-14  Week 3
Please indicate number of sessions your child will attend camp:
        Summer Camp  Week 1  Week 2  Week 3   
     Winter Camp:   Tuesday   Wednesday  Thursday
IMPORTANT
All forms must be completed and submitted before your child begins camp.
I will be paying by: Check Mastercard Visa Amex Discover
I give my child permission to attend all trips, and receive medical care in the case of emergency.
   Are there activities that are of special interest to your child?
  Are there any strong dislikes or fears that your child has that you feel the staff should be aware of?
 
  Does your child have any physical or emotional conditions that the staff should be aware of (allergies, speech etc.)
 
   
  Date of Application:


 

 

 

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Camp Gan Israel Chabad of West Bay 3871 Post Road Warwick, RI 02886 401-884-7888
A branch of the world's largest Jewish Camping network, Camp Gan Israel International

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