Printed from ChabadPlano.org

Winter Camp 2019 Registration

  • PARENT INFORMATION

  • If you have any trouble filling out this registration form or if you have any questions or concerns, please email yhorowitz@chabadplano.org 

  • Parent 1:

  • Parent 2:

  • fees:

    Early Bird Price until December 5: 
    $40/day per child; $35/day per child for 5 days or more

    Standard Price after December 5:
    $45/day per child; $40/day per child for 5 days or more

  • CAMPER INFORMATION

    Camper 1 : (to add additional campers scroll to bottom of form)

  • Medical questionaire

    Camper 1

  • EMERGENCY CONTACTS

  • Emergency Contact 1: (Please enter the information of someone other than yourself, who we can contact in the event that we cannot get in touch with you).

  • Emergency Contact 2:

  • PERMISSION

  • I hereby give permission for my child to participate in all camp activities. In addition I give Camp Gan Israel permission (a) To transport campers in connection with all camp activities; (b) To render necessary first aid or to arrange care by medical personnel, if deemed necessary; (c) To use photographs and videos and names of campers in printed material and websites associated with Camp Gan Israel; (d) I indemnify and hold harmless Camp Gan Israel from any liability or claim for any loss, injury, damage, or expense resulting or arising from my child’s participation in camp activities; and (e) The camp administration reserves the right to reconsider the enrollment of any camper if we feel the child’s needs or level of functioning or behavior cannot be accommodated, or if the child’s conduct limits his or her ability to participate in, or to benefit fully from, the programs and activities at Camp Gan Israel.

  • Pick a Date
  • Registration is confirmed with a minimum of $40 deposit per child. The balance is due by December 17th. If you are paying by check, the spot is not guaranteed until a deposit is received.

    Refund Policy:
    Until December 16th, 2019 - 100% refund. December 17 to 22, 2019 - 50% refund. During camp - 25% refund.
    In all cases the deposit is non-refundable.

  • $0.00
  •   
    Credit Card
    Billing Address
  • additional CAMPER INFORMATION

    Camper 2

  • Medical questionaire

    Camper 2

  • additional CAMPER INFORMATION

    Camper 3

  • Medical questionaire

    Camper 3

  • Please scroll back up to "payment options" to submit this form.

  • Should be Empty:
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