Summer Camp @ Gan Menachem

Summer Camp @ Gan Menachem
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Home Phone Number
Format: (000) 000-0000.
Mobile Number
Format: (000) 000-0000.
Email Address
example@example.com
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select Camp shirt size
Please provide any medical or dietary restrictions you have

School Information
Preschool Attending
Preschool Phone Number
Format: (000) 000-0000.

Family Information
Parent/Guardian's Name

First NameLast Name
Contact Phone Number
Format: (000) 000-0000.
E-mail Address
example@example.com

Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Format: (000) 000-0000.

Weeks Atttending: (Earlybird: $280 per week until Feb 28th, 2025. $325 from Mar 1st)
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Registration Fee
$100.00

Total

$0.00
Payment Methods

Choose from one of the PayPal options to make your payment.
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