Register

$50 non-refundable registration fee per camper due with registration.
Family Information:
Family Name:*

Family Address:*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number:*

Area Code Phone Number
E-mail:*
Mother's Full Name:*
First Name Last Name
Mother's Hebrew Name:*
Mother's Phone Number:*

Area Code Phone Number
Father's Full Name:*
First Name Last Name
Father's Hebrew Name:*
Father's Phone Number:*

Area Code Phone Number
Emergency Contact Info:
Emergency Contact Name #1:*
First Name Last Name
Emergency Contact Phone Number #1:*

Area Code Phone Number
Relationship:*
Emergency Contact Name #2:*
First Name Last Name
Emergency Contact Phone Number #2:*

Area Code Phone Number
Relationship:*
Pediatrician Name:*
Prefix First Name Last Name
Pediatrician Phone Number:

Area Code Phone Number
Insurance Policy #:*
Camper Information:
Camper Name:*
Gender:*

MF
Date of Birth:*

Month Day Year
Hebrew Birthday:*
School:*
Entering Grade:*
Health Notes:
Medication:
Allergies:
Health Problems or Disabilities:
Sessions Attending:
Early Bird Price: $300 per week · $1,800 for the full summer (register by March 31)
Please select all that apply:* Select Full Summer OR individual weeks, not both.

Full summer (All 6 Weeks) - $1800Week 1: June 21 - June 25, 2027 - $300Week 2: June 28 - July 2, 2027 - $300Week 3: July 5 - 9, 2027 - $300Week 4: July 12 - 16, 2027 - $300Week 5: July 19 - 23, 2027 - $300Week 6: July 26 - 31, 2027 - $300
Promo Code
$10 - T-Shirt Fee Per Camper
Discount
Photos Please reach out via email if you do not wish for your child to be photographed.

I grant permission for Camp Gan Israel to photograph my child and use these images on its website or in publicly displayed promotional materials.
Scholarship:
We believe camp is for every child, and we are committed to making the experience accessible to all families. Scholarships are available for families in need. Please contact Rabbi Yeruchem Engel at 720-568-0812 to inquire about a scholarship. Scholarships are limited and awarded based on financial need on a first-come, first-served basis.
Payment Information:
IMPORTANT: All forms must be completed and submitted before your child begins camp.
I authorize Camp Gan Israel to charge my card non-refundable registration fees in the amount of:*

Registration Fee: $50
PAYMENT & PARENTAL CONSENT*

I understand that the weekly fee is due each Monday. My credit card on file will be charged unless alternate arrangements have been made.I agree to indemnify and hold harmless Gan Israel and its employees in the event of injury to my child, G‑d forbid.I give my child permission to participate in all activities and authorize medical treatment to be administered in the event of an emergency.
Parent/Guardian Signature (Print Full Name):*
Total

$50.00

I would like to pay today:Full amount$50.00 minimum$

Payment:

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Should be Empty:

This page uses TLS encryption to keep your data secure.

Family Information:

Emergency Contact Info:

Camper Information:

Health Notes:

Sessions Attending:

Scholarship:

Payment Information: