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Winter Camp - Registration Form

 

Camp Gan Israel welcomes children
from ages 4 to 12 for our
Winter Camp Program!

Please use a separate form for each child
or complete and send in the PDF Registration Form found here.

Parent Information
Name
 

Last

First Names

 
Address
  Address
Postal Code  
Contact Info
  Home Phone
   
 
  Father's Work
Father's Cell
Father's Email
    Mother's Work
Mother's Cell
Mother's Email
Emergency Contact Info
  Name

Phone
Relationship


Cell



Family Physician

  Name
Phone
 
         
Camper Information
Name
  Last
First
Hebrew
Date of Birth (D/M/Y)
  Age
Gender
Schools
  Grade
School
Hebrew School

Alberta Health #

  Card Number
   
 
       

Additional Information

Camp Location: Chabad Lubavitch Calgary Campus

 
Camp Fees:

Gan Israel Winter Camp Fee
includes all outings, field trips,
lunches and snacks served daily!!

Full Day Program:

Prices below reflect the post-Early Bird Special pricing.
See note below for details.

All 5 Days: $50 per day
Individual Days: $52 per day

   
Extended Care: AM: $8 per day
PM: $8 per day
AM & PM: $12 per day
 
 
   
Please check all days that your child will attend:
 
Days Attending Extended Care
Monday, Dec. 31 AM PM
Tuesday, Jan. 1 AM PM
Wednesday, Jan. 2 AM PM
Thursday, Jan. 3 AM PM
Friday, Jan. 4 AM
  Do you have a Camp T-Shirt?

Yes
No


If you don't have a camp t-shirt: face

Select Size

PAYMENT
 
 

All forms must be completed and submitted before your child begins camp.

Please select number of days attending:

CAMP FEES:
YOUR TOTAL COST:


EXTENDED CARE - AM
EXTENDED CARE - PM
EXTENDED CARE - AM & PM

T-SHIRT

Please be sure to add up the total for the CAMP FEES, EXTENDED CARE, & CAMP T-SHIRT as applicable. Thank you for your cooperation.

Grand Total:

 

 

 

Payment Method
*cheque payments are to be made payable to Chabad Lubavitch of Alberta*

Card Type

Cardholder Name

Card Number

Expiration Date

 

I give my child permission to attend all trips, and receive medical care in the case of emergency.
I hereby permit the use of pictures that may have my child in them for Camp Gan Israel's website and future Chabad publications.
 
  Name of Parent or Legal Guardian who submitted this form:
   

 

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Camp Gan Israel 134 Forge Road SE Calgary, AB T2H 0S8 Canada 403-238-4880 Ext. 110
A branch of the world's largest Jewish Camping network, Camp Gan Israel International

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