CGI UES Application 2023

Dear Parents,

Welcome to a brand new year of Camp Gan Israel! Thank you for your interest. We are so excited to once again be housed in the beautiful Moise Safra Center at 130 East 82nd Street and Chabad Upper East Side at 419 East 77th Street. Please complete the application below. Approval of application is pending review. Please email camp@chabaduppereastside.com with any questions or call 917-952-1474. Check out chabadyf.com for more information. Looking forward to an amazing Summer 2023!

Thank you!

Rabbi Moishe & Cheved Krasnjansky

Camp Gan Israel Directors

Camp Dates:

Mini Gan Israel: June 27 - August 16

Gan Israel: June 26 - August 15

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Mini Gan Israel:

Campers ages 2 - 3 years old

Monday-Thursday

9:15-2:30 (Friday 1:00)

Children must be 2 by June 2023 to attend.

Located at Chabad Upper East Side 419 E 77th St

Gan Israel:

Campers ages 4 - 8 years old

Monday-Thursday

9:15-3:45 (Friday 1:30)

Located at Moise Safra Center 130 E 82nd St

Children Must be 4 or turning 4 by November 2023

Application Summer 2023

Child #1:

Division*

Child's Name*

First NameLast Name

Gender*

FemaleMale

Child's Nickname

Child's Hebrew Name

Date of Birth*

Would you like to enroll a 2nd child?*

YesNo

Child #2:

Division*

Child's Name*

First NameLast Name

Gender*

FemaleMale

Child's Nickname

Child's Hebrew Name

Date of Birth*

Would you like to enroll a 3rd child?

YesNo

Child #3:

Division*

Child's Name*

First NameLast Name

Gender*

FemaleMale

Child's Nickname

Child's Hebrew Name

Date of Birth*

Please Note: Your child must be 2 years old by June 1st, 2023. We regret that we cannot accept children younger than that.

Parent's Home Address*

Street Address

Apartment Number

CityState

Zip CodeCountry

Home Phone Number

Area CodePhone Number

Mother's Full Name*

First NameLast Name

Mother's Hebrew Name

Is Mother Jewish?*

YesNoConverted

Is Maternal Grandmother Jewish?*

YesNoConverted

Mother's E-mail*

Mother's Work Phone Number

Area CodePhone Number

Mother's Cell Phone Number*

Area CodePhone Number

Any Conversions or Adoption (child, parent or grandparents)?*

YesNo

If yes, please attach the conversion documents.

Upload a File

Father's Full Name*

First NameLast Name

Father's Hebrew Name

Is Father Jewish?*

YesNoConverted

Father's Work Phone Number

Area CodePhone Number

Father's Cell Phone Number

Area CodePhone Number

Father's E-mail

Parent's Marital Status*

Are you affiliated with any Synagogue?

If Yes, Which Synagogue?

Please provide 2 family references:

Refereance name and number

Is your child currently attending school?*

If Yes, Which School?

Child's School Contact Name

Child's School Phone Number

Area CodePhone Number

Are there any issues with your child that we should be aware of?

Is s/he currently receiving any services?

Notes:

How did you hear about us?*

For Child #2:

Is your child currently attending school?

If Yes, Which School?

Child's School Contact Name

Child's School Phone Number

Area CodePhone Number

Are there any issues with your child that we should be aware of?

Is s/he currently receiving any services?

Notes:

For Child #3:

Is your child currently attending school?

If Yes, Which School?

Child's School Contact Name

Child's School Phone Number

Area CodePhone Number

Are there any issues with your child that we should be aware of?

Is s/he currently receiving any services?

Notes:

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Chabad Upper East Side - Gan Israel Day Camp

Financial Agreement

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