Camp Gan Israel Central PA

Camp Gan Israel Central PA

Summer Camp Registration 2026
How many children would you like to register for camp?
Child 1 Information
First Name
Last Name
Hebrew Name
Gender
Date of Birth

MonthDayYear
Date
Grade Entering September 2026
T-shirt Size (Child 1)
Please specify if your child has any known allergies
Are there any medical or behavioral concerns that your child's counselor/s should be aware of?
Child 2 Information
First Name (Child 2)
Last Name (Child 2)
Hebrew Name (Child 2)
Gender (Child 2)
Date of Birth (Child 2)

MonthDayYear
Date
T-shirt Size (Child 2)
Grade Entering September 2026 (Child 2)
Please specify if your child has any known allergies
Are there any medical or behavioral concerns that your child's counselor/s should be aware of?
Child 3 Information
Please specify if your child has any known allergies
Are there any medical or behavioral concerns that your child's counselor/s should be aware of?
First Name (Child 3)
Last Name (Child 3)
Hebrew Name (Child 3)
Gender (Child 3)
T-shirt Size (Child 3)
Date of Birth (Child 3)

MonthDayYear
Date
Grade Entering September 2026 (Child 3)
Child 4 Information
First Name (Child 4)
Last Name (Child 4)
Hebrew Name (Child 4)
T-shirt Size (Child 4)
Gender (Child 4)
Date of Birth (Child 4)

MonthDayYear
Date
Grade Entering September 2026 (Child 4)
Please specify if your child has any known allergies
Are there any medical or behavioral concerns that your child's counselor/s should be aware of?
Parent/Guardian Information
Parent/Guardian 1 Full Name

First NameLast Name
Relationship to Child(ren)
Phone Number (Parent/Guardian 1)
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (Parent/Guardian 1)
example@example.com
Parent/Guardian 2 Full Name

First NameLast Name
Relationship to Child(ren) (Parent/Guardian 2)
Phone Number (Parent/Guardian 2)
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (Parent/Guardian 2)
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Is the natural mother of the child/ren Jewish?*
Is the natural father of the child/ren Jewish?*
Were there any conversions or adoptions in the family? *
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Relationship to Child(ren) (Emergency Contact)
Phone Number (Emergency Contact)
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (Emergency Contact)
example@example.com
Program Selection and Deposit
Week Selection
Are you interested in early care or after care?
Deposit Payment
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Deposit
Pay a $100 deposit per camper to secure your spot!

$100.00 Quantity

Total

$0.00
Should be Empty:

Camp Gan Israel Central PA

Child 1 Information

Child 2 Information

Child 3 Information

Child 4 Information

Parent/Guardian Information

Emergency Contact Information

Program Selection and Deposit

Deposit Payment