Summer Camp @ Gan Menachem

Summer Camp @ Gan Menachem
Child's Name*

First NameLast Name
Birth Date*

MonthDayYear
Home Phone Number
Mobile Number*
Email Address*
example@example.com
Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select Camp shirt size*

SmallX-small
Please provide any medical or dietary restrictions you have*

School Information
Preschool Attending*
Preschool Phone Number*

Family Information
Parent/Guardian's Name*

First NameLast Name
Contact Phone Number*
E-mail Address*
example@example.com

Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

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

June 15th - June 19thJune 22nd - June 26thJune 29th - July 3rdJuly 6th - July 10thJuly 13th - July 17thJuly 20th - July 24thJuly 27th - July 31stAugust 3rd - August 7th
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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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