ONLINE REGISTRATION FORM
Camp Gan Israel SF Summer 2026
Parents Information
Parent 1
*
First Name
Last Name
Parent 1 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent 1 Cell Number
*
Please enter a valid phone number.
Parent 1 Work Number
*
Please enter a valid phone number.
Parent 1 Email
*
example@example.com
Parent 2 Name
*
First Name
Last Name
Parent 2 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent 2 Cell Number
*
Please enter a valid phone number.
Parent 2 Work Number
Please enter a valid phone number.
Parent 2 Email
*
example@example.com
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Camper/s Information
How many campers do you want to register?
*
Please Select
1
2
3
Total Registration Fee ($150 per Camper)
Camper 1
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Age
*
Please Select
4
5
6
7
8
9
10
11
12
13
Grade Entering
*
Please Select
K
1
2
3
4
5
6
7
8
9
School
*
Hebrew School
Which Sessions will camper 1 attend?
*
Please Select
Full Session: (5 Weeks: June 29 - July 30): $2150
Session #1: (Weeks 1 & 2: June 29 - July 10): $900
Session #2: (Weeks 3 & 4: July 13 - July 24): $900
Session #3: (Weeks 5 July 27 - July 30) $450
Sessions #1 & #2 : (Weeks 1-4: June 29 - July 24): $1800
Sessions #1 & #3 : (Weeks 1-2 & 5: June 29 - July 10, July 27-30): $1350
Sessions #2 & #3 : (Weeks 3-5: July 13 - July 30): $1350
Allergies, medications, and anything else we should be aware of:
*
Total for Camper 1
Camper 2
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Age
*
Please Select
4
5
6
7
8
9
10
11
12
13
Grade Entering
*
Please Select
K
1
2
3
4
5
6
7
8
9
School
*
Hebrew School
Which Sessions will camper 2 attend?
*
Please Select
Full Session: (5 Weeks: June 29 - July 30): $2150
Session #1: (Weeks 1 & 2: June 29 - July 10): $900
Session #2: (Weeks 3 & 4: July 13 - July 24): $900
Session #3: (Weeks 5 July 27 - July 30) $450
Sessions #1 & #2 : (Weeks 1-4: June 29 - July 24): $1800
Sessions #1 & #3 : (Weeks 1-2 & 5: June 29 - July 10, July 27-30): $1350
Sessions #2 & #3 : (Weeks 3-5: July 13 - July 30): $1350
Allergies, medications, and anything else we should be aware of:
*
$25 Sibling Discount
Total For Camper 2
Camper 3
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Age
*
Please Select
4
5
6
7
8
9
10
11
12
13
Grade Entering
*
Please Select
K
1
2
3
4
5
6
7
8
9
School
*
Hebrew School
Which Sessions will camper 3 attend?
*
Please Select
Full Session: (5 Weeks: June 29 - July 30): $2150
Session #1: (Weeks 1 & 2: June 29 - July 10): $900
Session #2: (Weeks 3 & 4: July 13 - July 24): $900
Session #3: (Weeks 5 July 27 - July 30) $450
Sessions #1 & #2 : (Weeks 1-4: June 29 - July 24): $1800
Sessions #1 & #3 : (Weeks 1-2 & 5: June 29 - July 10, July 27-30): $1350
Sessions #2 & #3 : (Weeks 3-5: July 13 - July 30): $1350
Allergies, medications, and anything else we should be aware of:
*
$25 Sibling Discount
Total for Camper 3
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Emergency Contact Information
1. Name
*
First Name
Last Name
1. Phone Number
*
Please enter a valid phone number.
1. Relationship to Camper/s
*
2. Name
*
First Name
Last Name
2. Phone Number
*
Please enter a valid phone number.
2. Relationship to Camper/s
*
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Pediatrician & Insurance Information
Pediatrician Name
*
First Name
Last Name
Pediatrician Phone Number
*
Please enter a valid phone number.
Insurance
*
Policy Number
*
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How did you hear about CGI SF?
*
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Emergency Waiver
The Happy Shalom School (hereinafter called "HSS") operates Camp Gan Israel SF.
I declare that the applicant is my child / or the applicant is fully under my guardianship and care ("my child").
I have to the very best of my knowledge fully described the health history of my child.
My child has permission to engage in all prescribed camp activities and field trips except as noted.
I agree that I am responsible for keeping HSS fully informed of any changes in the health and emergency information.
I hereby permit the camp staff to administer my child’s routine medications as listed above.
In the case of an emergency (G-d forbid) where medical treatment is required (during camp or related to camp), I hereby declare that my child has the medical insurance to cover all of the costs and that I am otherwise fully responsible for all medical costs incurred and I will not hold HSS responsible at all.
If in an emergency HSS is unable to contact me or an authorised person, HSS and its agents have my authority to transport my child to the nearest hospital and to secure all necessary medical treatment for my child, including anaesthesia, X-rays, and any other medical treatment deemed necessary.
I hereby release and forever discharge HSS and its officers, trustees, employees, and staff members from all liability of any kind for any claim, demand, action, cause of action, damage, judgement, cost or expense that arises out of, or relates in any manner to my child’s attendance and participation in the activities involved and incidental to the Camp Gan Israel camp.
I am responsible for any loss, damage or destruction caused by my child to any property of Camp Gan Israel/Chabad of San Francisco/The Happy Shalom School or to any property for which HSS is liable for charges.
I hereby allow HSS to transport my child on HSS provided transportation.
I hereby declare that the information provided on this form is accurate and complete.
Agreement
*
I acknowledge that I have fully read this waiver and that it applies to all the children I have listed in this registration and I agree to the terms herein.
Type a question
*
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Payment Information
Total Camp Tuition
How do you want to pay?
*
Please Select
Registration Fee +3% CC Fee
2 Installments +3% CC Fee
Pay Full Now +3% CC Fee
Each Installment
Total due now(hidden)
Total due now
How would you like to pay the rest of the bill?
*
Credit Card
Check
*
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Last Name
Credit Card Number
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Card Expiration
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