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Register

We are thrilled to have you join Camp Gan Israel of Marin summer 2023!

Week 1: June 26 - June 30
Week 2: July 3 - July 7
Week 3: July 10 - July 14

Join for all 3 weeks and receive a discount!

If you have financial hardships, please reach out to [email protected] to see if their is any scholarships available
1. Child/ren’s Information
Number of children being registered:*
Child 1*

First Name Last Name
Birth Date*

Month Day Year
Gender*

MaleFemale
Sessions:*

Week 1Week 2Week 3All three weeks
Child 2

First Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Sessions:

Week 1Week 2Week 3All three weeks
Child 3

First Name Last Name
Birth Date

Month Day Year
Gender

MaleFemale
Sessions:

Week 1Week 2Week 3All three weeks
2. Parent information
Mother's info

First Name Last Name
Cell Phone

Area Code Phone Number
E-mail Primary email
Father's info

First Name Last Name
E-mail
Cell Phone

Area Code Phone Number
3. Emergency Information
Emergency Contact

First Name Last Name
Phone Number

Area Code Phone Number
Relationship
Pediatrician & Insurance

First Name Last Name
Phone Number

Area Code Phone Number
Insurance
Policy #
4. Payment Information
Total

$0.00

Payment

Credit Card Paypal Check/Cash

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 newsletters.
General comments - please include any allergies
Should be Empty:

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