Please fill out this form as soon as possible to reserve your spot!The application includes a minimum $25 non-refundable deposit. Once this application is submitted, we will send you a link to the health & child information form.Any questions? Don't hesitate to call us at 281-724-1554 or email [email protected] See Dates & Rates Get ready for a most dynamic summer experience! Jam-packed with awesome activities, fun, friends, amazing staff and incredible Jewish spirit! Current Date*MonthDayYear 1. Child/ren’s InformationChild 1*First NameMiddle NameLast NameBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGender*MaleFemaleRegister 1st Child*Full Season (two weeks): $450 or One Week: $250Full Season1st Week Only2nd Week OnlyChild 2First NameMiddle NameLast NameBirth Date1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGenderMaleFemaleRegister 2nd Child2nd Sibling Discount Applied - Full Season (two weeks): $405 or One Week: $225Full Season1st Week Only2nd Week OnlyIf you have additional children, please submit the form again with the additional names. 2. Parent informationHome Address*Street AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryHome PhoneArea CodePhone NumberParent 1*Primary contact for this registration & will receive the email confirmationMotherFatherParent Name*First NameLast NameJewish BackgroundE-mail*Primary emailCell Phone*Area CodePhone NumberWork PhoneArea CodePhone NumberParent 2FatherMotherParent NameFirst NameLast NameJewish BackgroundE-mailCell PhoneArea CodePhone NumberWork PhoneArea CodePhone NumberFamily InfoKindly share any relevant family info. Which of the parents are Jewish? Are parents married? Any conversions or adoptions?3. Payment InformationScholarship DonationI'd like to make a donation to the Camp Scholarship Fund for another child to be able to attend$Total$0.00I would like to pay today: Full amount$25.00 minimum $ A $25 non-refundable application fee/deposit is due with this application. This amount will count towards your tuition. You may pay full or partial tuition with your application today. Balance will be due two weeks before camp, at which point we can charge your card or you may make prior alternative payment arrangements.PaymentCredit Card Paypal Check Credit CardVisaMasterCardAmerican ExpressDiscoverCredit Card TypeCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2022202320242025202620272028202920302031Expiration YearPaypal has been selected. Payment will take place on the next page.4. Additional InformationAgreement*All must be selected. If you have any questions or hesitations, please contact us.I hereby give permission for my child to participate in all Camp Gan Israel activities and trips.I hereby consent to the administration of Camp Gan Israel to take whatever medical meaures they deem necessary for my child, in the event of a medical EMERGENCY in which they can't reach me.I authorize Camp Gan Israel to have and use photographs and videos of the person named on this application as needed for educational and public relations purposes.I will notify the camp if any of my children enroled are not feeling well and will keep my child home until recovery to help prevent spread of any illness.Where did you hear about Camp Gan Israel - Bay Area?What is your main reason for choosing to send your child/ren to Camp Gan Israel this summer?Are you interested in more info about early or after care?Other commentsShould be Empty: Submit This page uses TLS encryption to keep your data secure.