Welcome to Camp Gan Israel Registration CGI 2023 Summer Camp Hosts Diane & Ben OBM Docktor Lunch, snacks & all trips are included! At no extra cost. Family discount! 5% off for all additional siblings. Refer a friend program! You and your friend will receive a $50 tuition credit. GanIsrael.ca/refer Section 1. Family Information Father's Full Name* Father's First Name Father's Last Name Father's E-mail* Father's Mobile Number* Area Code Phone Number Mother's Full Name* Mother's First Name Mother's Last Name Mother's E-mail* Mother's Mobile Number* Area Code Phone Number Home Address* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Home Phone Number Area Code Phone Number Marital Status* Comments can be filled in the box below MarriedDivorced Comments How Did You Here About Camp Gan Israel? _____________________________________________________________________ Next Section: Camper Information Section 2. Camper Information Child Info Child One Full Name* First Name Last Name Child One Hebrew Name* Child One Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Child One Gender* MaleFemale Child One School Attending* Child One Grade Finishing in 2022* Child One Alberta Health* Medical Info Does your child have any allergies?* NoYes Please list all allergies:* medication, food, others Information needed for our staff regarding allergies:* Is your child presently taking any medication?* NoYes List all medication presently being taken* Is your child up to date with all immunizations?* NoYes List which ones you are behind in* May your child use camp-provided sunscreen for re-application?* Campers must bring their own sunscreen daily. We provide sunscreen only for re-application during outdoor trips, so there is less they need to carry. Yes, no issueNo, my child can only use sunscreen brought from home Does your child have any restrictions in: Biking* NoYes Please explain:* Sports* NoYes Please explain:* Hiking* NoYes Please explain:* Swimming* NoYes Please explain:* Other* NoYes Please explain:* Camp Sessions Age Group Selection* Select camper's age group Kiddie Camp Half Day (Ages 3 or 4) Kiddie Camp Full Day (Ages 3 or 4) Kindergarten to Grade 3 (From Age 5) Grade 4 and Up Tiered Pricing Selection* Rates show after you select an age group Tiered Pricing Selection* Select Rate - Kiddie Camp Half Day Full (Cost Rate) $205 Standard (Affordable Rate) $168 Subsidized (Scholarship Rate) $123 Tiered Pricing Selection* Select Rate - Kiddie Camp Full Day Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Kindergarten to Grade 3 Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate Options - Grade 4 and up Full (Cost Rate) $370 Standard (Affordable Rate) $305 Subsidized (Scholarship Rate) $230 Tiered rates info - HIDETiered rates info - SHOW Week 1. July 3-7 / $205Week 2. July 10-14 / $205Week 3. July 17-21 / $205Week 4. July 24-28 / $205Week 5. July 31-Aug 4 / $205Week 6. Aug 08-11 / $164 (No camp on Heritage day) Week 1. July 3-7 / $168Week 2. July 10-14 / $168Week 3. July 17-21 / $168Week 4. July 24-28 / $168Week 5. July 31- Aug 4 / $168Week 6. Aug 08-11 / $134 (No camp on Heritage day) Week 1. July 3-7 / $123Week 2. July 10-14 / $123Week 3. July 17-21 / $123Week 4. July 24-28 / $123Week 5. July 31- Aug 4 / $123Week 6. Aug 08-11 / $98 (No camp on Heritage day) Week 1. July 3-7 / $350Week 2. July 10-14 / $350Week 3. July 17-21 / $350Week 4. July 24-28 / $350Week 5. July 31- Aug 4 / $350Week 6. Aug 08-11 / $280 (No camp on Heritage day) Week 1. July 3-7 / $285Week 2. July 10-14 / $285Week 3. July 17-21 / $285Week 4. July 24-28 / $285Week 5. July 31- Aug 4 / $285Week 6. Aug 08-11 / $228 (No camp on Heritage day) Week 1. July 3-7 / $210Week 2. July 10-14 / $210Week 3. July 17-21 / $210Week 4. July 24-28 / $210Week 5. July 31- Aug 4 / $210Week 6. Aug 08-11 / $169 (No camp on Heritage day) Week 1. July 3-7 / $370Week 2. July 10-14 / $370Week 3. July 17-21 / $370Week 4. July 24-28 / $370Week 5. July 31- Aug 4 / $370Week 6. Aug 08-11 / $296 (No camp on Heritage day) Week 1. July 3-7 / $305Week 2. July 10-14 / $305Week 3. July 17-21 / $305Week 4. July 24-28 / $305Week 5. July 31- Aug 4 / $305Week 6. Aug 08-11 / $244 (No camp on Heritage day) Week 1. July 3-7 / $230Week 2. July 10-14 / $230Week 3. July 17-21 / $230Week 4. July 24-28 / $230Week 5. July 31- Aug 4 / $230Week 6. Aug 08-11 / $184 (No camp on Heritage day) After Early Bird Price Adjustment* $15 added per week 1 Weeks 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 Weeks Select the amount of weeks your child is registering Additional Options Extended Care I don't need extended care Early Care and After Care Early Care Only After Care Only Extended Care AM 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Extended Care AM Only 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM Only 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large Second Camp Tshirt $15.Camp Tshirts must be worn on all field trips. I don't need a second camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large LUNCH and SNACKS and all TRIPS included in Registration price! Early Bird! Prices on until May 15th. After May 15th add $15 per week. Family Discount! 5% for each additional sibling. Refer A Friend Program! You and your friend receive $50 off camp tuition! _____________________________________________________________________ Next: Add Another ChildSkip to Consent and Payment Child Two Info Child Two Full Name* First Name Last Name Child Two Hebrew Name* Child Two Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Child Two Gender* MaleFemale Child Two School Attending* Child Two Grade Finishing in 2022* Child Two Alberta Health* Medical Info Does your child have any allergies?* NoYes Please list all allergies:* medication, food, others Information needed for our staff regarding allergies:* Is your child presently taking any medication?* NoYes List all medication presently being taken* Is your child up to date with all immunizations?* NoYes List which ones you are behind in* May your child use camp-provided sunscreen for re-application?* Campers must bring their own sunscreen daily. We provide sunscreen only for re-application during outdoor trips, so there is less they need to carry. Yes, no issueNo, my child can only use sunscreen brought from home Does your child have any restrictions in: Biking* NoYes Please explain:* Sports* NoYes Please explain:* Hiking* NoYes Please explain:* Swimming* NoYes Please explain:* Other* NoYes Please explain:* Camp Sessions Age Group Selections* Select campers age group Kiddie Camp Half Day (Ages 3 or 4) Kiddie Camp Full Day (Ages 3 or 4) Kindergarten to Grade 3 (From Age 5) Grade 4 and Up Tiered Pricing Selection* Rates show after you select an age group Tiered Pricing Selection* Select Rate - Kiddie Camp Half Day Full (Cost Rate) $205 Standard (Affordable Rate) $168 Subsidized (Scholarship Rate) $123 Week 1. July 3-7 / $205Week 2. July 10-14 / $205Week 3. July 17-21 / $205Week 4. July 24-28 / $205Week 5. July 31-Aug 4 / $205Week 6. Aug 08-11 / $164 (No camp on Heritage day) Week 1. July 3-7 / $168Week 2. July 10-14 / $168Week 3. July 17-21 / $168Week 4. July 24-28 / $168Week 5. July 31- Aug 4 / $168Week 6. Aug 08-11 / $134 (No camp on Heritage day) Week 1. July 3-7 / $123Week 2. July 10-14 / $123Week 3. July 17-21 / $123Week 4. July 24-28 / $123Week 5. July 31- Aug 4 / $123Week 6. Aug 08-11 / $98 (No camp on Heritage day) Tiered Pricing Selection* Select Rate - Kiddie Camp Full Day Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Kind. to Grade 3 Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Week 1. July 3-7 / $350Week 2. July 10-14 / $350Week 3. July 17-21 / $350Week 4. July 24-28 / $350Week 5. July 31- Aug 4 / $350Week 6. Aug 08-11 / $280 (No camp on Heritage day) Week 1. July 3-7 / $285Week 2. July 10-14 / $285Week 3. July 17-21 / $285Week 4. July 24-28 / $285Week 5. July 31- Aug 4 / $285Week 6. Aug 08-11 / $228 (No camp on Heritage day) Week 1. July 3-7 / $210Week 2. July 10-14 / $210Week 3. July 17-21 / $210Week 4. July 24-28 / $210Week 5. July 31- Aug 4 / $210Week 6. Aug 08-11 / $169 (No camp on Heritage day) Tiered Pricing Selection* Select Rate - Grade 4 and up Full (Cost Rate) $370 Standard (Affordable Rate) $305 Subsidized (Scholarship Rate) $230 Week 1. July 3-7 / $370Week 2. July 10-14 / $370Week 3. July 17-21 / $370Week 4. July 24-28 / $370Week 5. July 31- Aug 4 / $370Week 6. Aug 08-11 / $296 (No camp on Heritage day) Week 1. July 3-7 / $305Week 2. July 10-14 / $305Week 3. July 17-21 / $305Week 4. July 24-28 / $305Week 5. July 31- Aug 4 / $305Week 6. Aug 08-11 / $244 (No camp on Heritage day) Week 1. July 3-7 / $230Week 2. July 10-14 / $230Week 3. July 17-21 / $230Week 4. July 24-28 / $230Week 5. July 31- Aug 4 / $230Week 6. Aug 08-11 / $184 (No camp on Heritage day) After Early Bird Price Adjustment* $15 added per week 1 Weeks 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 Weeks Select the amount of weeks your child is registering Additional Options Extended Care I dont need extended care Early Care and After Care Early Care Only After Care Only Extended Care AM Only 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM Only 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Extended Care AM 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large Second Camp Tshirt $15.Camp Tshirts must be worn on all field trips. I don't need a second camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large LUNCH and SNACKS and all TRIPS included in Registration price! Early Bird! Prices on until May 15th. After May 15th add $15 per week. Family Discount! 5% for each additional sibling. Refer A Friend Program! You and your friend receive $50 off camp tuition! _____________________________________________________________________ Next: Add Another ChildSkip to Consent and Payment Child Three Info Child Three Full Name* First Name Last Name Child Three Hebrew Name* Child Three Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Child Three Gender* MaleFemale Child Three School Attending* Child Three Grade Finishing in 2022* Child Three Alberta Health* Medical Info Does your child have any allergies?* NoYes Please list all allergies:* medication, food, others Information needed for our staff regarding allergies:* Is your child presently taking any medication?* NoYes List all medication presently being taken* Is your child up to date with all immunizations?* NoYes List which ones you are behind in* May your child use camp-provided sunscreen for re-application?* Campers must bring their own sunscreen daily. We provide sunscreen only for re-application during outdoor trips, so there is less they need to carry. Yes, no issueNo, my child can only use sunscreen brought from home Does your child have any restrictions in: Biking* NoYes Please explain:* Sports* NoYes Please explain:* Hiking* NoYes Please explain:* Swimming* NoYes Please explain:* Other* NoYes Please explain:* Camp Sessions Age Group Selection* Select campers age group Kiddie Camp Half Day (Ages 3 or 4) Kiddie Camp Full Day (Ages 3 or 4) Kindergarten to Grade 3 (From Age 5) Grade 4 and Up Tiered Pricing Selection* Rates show after you select an age group Tiered Pricing Selection* Select Rate - Kiddie Camp Half Day Full (Cost Rate) $205 Standard (Affordable Rate) $168 Subsidized (Scholarship Rate) $123 Tiered Pricing Selection* Select Rate - Kiddie Camp Full Day Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Kind. to Grade 3 Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Grade 4 and up Full (Cost Rate) $370 Standard (Affordable Rate) $305 Subsidized (Scholarship Rate) $230 Week 1. July 3-7 / $205Week 2. July 10-14 / $205Week 3. July 17-21 / $205Week 4. July 24-28 / $205Week 5. July 31-Aug 4 / $205Week 6. Aug 08-11 / $164 (No camp on Heritage day) Week 1. July 3-7 / $168Week 2. July 10-14 / $168Week 3. July 17-21 / $168Week 4. July 24-28 / $168Week 5. July 31- Aug 4 / $168Week 6. Aug 08-11 / $134 (No camp on Heritage day) Week 1. July 3-7 / $123Week 2. July 10-14 / $123Week 3. July 17-21 / $123Week 4. July 24-28 / $123Week 5. July 31- Aug 4 / $123Week 6. Aug 08-11 / $98 (No camp on Heritage day) Week 1. July 3-7 / $350Week 2. July 10-14 / $350Week 3. July 17-21 / $350Week 4. July 24-28 / $350Week 5. July 31- Aug 4 / $350Week 6. Aug 08-11 / $280 (No camp on Heritage day) Week 1. July 3-7 / $285Week 2. July 10-14 / $285Week 3. July 17-21 / $285Week 4. July 24-28 / $285Week 5. July 31- Aug 4 / $285Week 6. Aug 08-11 / $228 (No camp on Heritage day) Week 1. July 3-7 / $210Week 2. July 10-14 / $210Week 3. July 17-21 / $210Week 4. July 24-28 / $210Week 5. July 31- Aug 4 / $210Week 6. Aug 08-11 / $169 (No camp on Heritage day) Week 1. July 3-7 / $370Week 2. July 10-14 / $370Week 3. July 17-21 / $370Week 4. July 24-28 / $370Week 5. July 31- Aug 4 / $370Week 6. Aug 08-11 / $296 (No camp on Heritage day) Week 1. July 3-7 / $305Week 2. July 10-14 / $305Week 3. July 17-21 / $305Week 4. July 24-28 / $305Week 5. July 31- Aug 4 / $305Week 6. Aug 08-11 / $244 (No camp on Heritage day) Week 1. July 3-7 / $230Week 2. July 10-14 / $230Week 3. July 17-21 / $230Week 4. July 24-28 / $230Week 5. July 31- Aug 4 / $230Week 6. Aug 08-11 / $184 (No camp on Heritage day) After Early Bird Price Adjustment* $15 added per week 1 Weeks 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 Weeks Select the amount of weeks your child is registering LUNCH and SNACKS and all TRIPS included in Registration price! Early Bird! Prices on until May 15th. After May 15th add $15 per week. Family Discount! 5% for each additional sibling. Refer A Friend Program! You and your friend receive $50 off camp tuition! Extended Care I don't need extended care Early Care and After Care Early Care Only After Care Only Extended Care AM Only 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM Only 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Extended Care AM 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large Second Camp Tshirt $15.Camp Tshirts must be worn on all field trips. I don't need a second camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large _____________________________________________________________________ Next: Add Another ChildSkip to Consent and Payment Child Four Info Child Four Full Name* First Name Last Name Child Four Hebrew Name* Child Four Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Child Four Gender* MaleFemale Child Four School Attending* Child Four Grade Finishing in 2022* Child Four Alberta Health* Medical Info Does your child have any allergies?* NoYes Please list all allergies:* medication, food, others Information needed for our staff regarding allergies:* Is your child presently taking any medication?* NoYes List all medication presently being taken* Is your child up to date with all immunizations?* NoYes List which ones you are behind in* May your child use camp-provided sunscreen for re-application?* Campers must bring their own sunscreen daily. We provide sunscreen only for re-application during outdoor trips, so there is less they need to carry. Yes, no issueNo, my child can only use sunscreen brought from home Does your child have any restrictions in: Biking* NoYes Please explain:* Sports* NoYes Please explain:* Hiking* NoYes Please explain:* Swimming* NoYes Please explain:* Other* NoYes Please explain:* Camp Sessions Age Group Selection Select campers age group Kiddie Camp Half Day (Ages 3 or 4) Kiddie Camp Full Day (Ages 3 or 4) Kindergarten to Grade 3 (From Age 5) Grade 4 and Up Tiered Pricing Selection* Rates show after you select an age group Tiered Pricing Selection* Select Rate - Kiddie Camp Half Day Full (Cost Rate) $205 Standard (Affordable Rate) $168 Subsidized (Scholarship Rate) $123 Tiered Pricing Selection* Select Rate - Kiddie Camp Full Day Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Kindergarten to Grade 3 Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Grade 4 and up Full (Cost Rate) $370 Standard (Affordable Rate) $305 Subsidized (Scholarship Rate) $230 Week 1. July 3-7 / $205Week 2. July 10-14 / $205Week 3. July 17-21 / $205Week 4. July 24-28 / $205Week 5. July 31-Aug 4 / $205Week 6. Aug 08-11 / $164 (No camp on Heritage day) Week 1. July 3-7 / $168Week 2. July 10-14 / $168Week 3. July 17-21 / $168Week 4. July 24-28 / $168Week 5. July 31- Aug 4 / $168Week 6. Aug 08-11 / $134 (No camp on Heritage day) Week 1. July 3-7 / $123Week 2. July 10-14 / $123Week 3. July 17-21 / $123Week 4. July 24-28 / $123Week 5. July 31- Aug 4 / $123Week 6. Aug 08-11 / $98 (No camp on Heritage day) Week 1. July 3-7 / $350Week 2. July 10-14 / $350Week 3. July 17-21 / $350Week 4. July 24-28 / $350Week 5. July 31- Aug 4 / $350Week 6. Aug 08-11 / $280 (No camp on Heritage day) Week 1. July 3-7 / $285Week 2. July 10-14 / $285Week 3. July 17-21 / $285Week 4. July 24-28 / $285Week 5. July 31- Aug 4 / $285Week 6. Aug 08-11 / $228 (No camp on Heritage day) Week 1. July 3-7 / $210Week 2. July 10-14 / $210Week 3. July 17-21 / $210Week 4. July 24-28 / $210Week 5. July 31- Aug 4 / $210Week 6. Aug 08-11 / $169 (No camp on Heritage day) Week 1. July 3-7 / $370Week 2. July 10-14 / $370Week 3. July 17-21 / $370Week 4. July 24-28 / $370Week 5. July 31- Aug 4 / $370Week 6. Aug 08-11 / $296 (No camp on Heritage day) Week 1. July 3-7 / $305Week 2. July 10-14 / $305Week 3. July 17-21 / $305Week 4. July 24-28 / $305Week 5. July 31- Aug 4 / $305Week 6. Aug 08-11 / $244 (No camp on Heritage day) Week 1. July 3-7 / $230Week 2. July 10-14 / $230Week 3. July 17-21 / $230Week 4. July 24-28 / $230Week 5. July 31- Aug 4 / $230Week 6. Aug 08-11 / $184 (No camp on Heritage day) After Early Bird Price Adjustment* $15 added per week 1 Weeks 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 Weeks Select the amount of weeks your child is registering Extended Care I don't need extended care Early Care and After Care Early Care Only After Care Only Extended Care AM Only 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM Only 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Extended Care AM 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large Second Camp Tshirt $15.Camp Tshirts must be worn on all field trips. I don't need a second camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large LUNCH and SNACKS and all TRIPS included in Registration price! Early Bird! Prices on until May 15th. After May 15th add $15 per week. Family Discount! 5% for each additional sibling. Refer A Friend Program! You and your friend receive $50 off camp tuition! _____________________________________________________________________ Next: Add Another ChildSkip to Consent and Payment Child Five Info Child Five Full Name* First Name Last Name Child Five Hebrew Name* Child Five Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Child Five Gender* MaleFemale Child Five School Attending* Child Five Grade Finishing in 2022* Child Five Alberta Health* Medical Info Does your child have any allergies?* NoYes Please list all allergies:* medication, food, others Information needed for our staff regarding allergies:* Is your child presently taking any medication?* NoYes List all medication presently being taken* Is your child up to date with all immunizations?* NoYes List which ones you are behind in* May your child use camp-provided sunscreen for re-application?* Campers must bring their own sunscreen daily. We provide sunscreen only for re-application during outdoor trips, so there is less they need to carry. Yes, no issueNo, my child can only use sunscreen brought from home Does your child have any restrictions in: Biking* NoYes Please explain:* Sports* NoYes Please explain:* Hiking* NoYes Please explain:* Swimming* NoYes Please explain:* Other* NoYes Please explain:* Camp Sessions Age Group Selection* Select campers age group Kiddie Camp Half Day (Ages 3 or 4) Kiddie Camp Full Day (Ages 3 or 4) Kindergarten to Grade 3 (From Age 5) Grade 4 and Up Tiered Pricing Selection* Rates show after you select an age group Tiered Pricing Selection* Select Rate - Kiddie Camp Half Day Full (Cost Rate) $205 Standard (Affordable Rate) $168 Subsidized (Scholarship Rate) $123 Tiered Pricing Selection* Select Rate - Kiddie Camp Full Day Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Kindergarten to Grade 3 Full (Cost Rate) $350 Standard (Affordable Rate) $285 Subsidized (Scholarship Rate) $210 Tiered Pricing Selection* Select Rate - Grade 4 and up Full (Cost Rate) $370 Standard (Affordable Rate) $305 Subsidized (Scholarship Rate) $230 Week 1. July 3-7 / $205Week 2. July 10-14 / $205Week 3. July 17-21 / $205Week 4. July 24-28 / $205Week 5. July 31-Aug 4 / $205Week 6. Aug 08-11 / $164 (No camp on Heritage day) Week 1. July 3-7 / $168Week 2. July 10-14 / $168Week 3. July 17-21 / $168Week 4. July 24-28 / $168Week 5. July 31- Aug 4 / $168Week 6. Aug 08-11 / $134 (No camp on Heritage day) Week 1. July 3-7 / $123Week 2. July 10-14 / $123Week 3. July 17-21 / $123Week 4. July 24-28 / $123Week 5. July 31- Aug 4 / $123Week 6. Aug 08-11 / $98 (No camp on Heritage day) Week 1. July 3-7 / $350Week 2. July 10-14 / $350Week 3. July 17-21 / $350Week 4. July 24-28 / $350Week 5. July 31- Aug 4 / $350Week 6. Aug 08-11 / $280 (No camp on Heritage day) Week 1. July 3-7 / $285Week 2. July 10-14 / $285Week 3. July 17-21 / $285Week 4. July 24-28 / $285Week 5. July 31- Aug 4 / $285Week 6. Aug 08-11 / $228 (No camp on Heritage day) Week 1. July 3-7 / $210Week 2. July 10-14 / $210Week 3. July 17-21 / $210Week 4. July 24-28 / $210Week 5. July 31- Aug 4 / $210Week 6. Aug 08-11 / $169 (No camp on Heritage day) Week 1. July 3-7 / $370Week 2. July 10-14 / $370Week 3. July 17-21 / $370Week 4. July 24-28 / $370Week 5. July 31- Aug 4 / $370Week 6. Aug 08-11 / $296 (No camp on Heritage day) Week 1. July 3-7 / $305Week 2. July 10-14 / $305Week 3. July 17-21 / $305Week 4. July 24-28 / $305Week 5. July 31- Aug 4 / $305Week 6. Aug 08-11 / $244 (No camp on Heritage day) Week 1. July 3-7 / $230Week 2. July 10-14 / $230Week 3. July 17-21 / $230Week 4. July 24-28 / $230Week 5. July 31- Aug 4 / $230Week 6. Aug 08-11 / $184 (No camp on Heritage day) Kiddie Camp Half Day Ages 3 or 4 Week 1. July 3-7 / $158Week 2. July 10-14 / $158Week 3. July 17-21 / $158Week 4. July 24-28 / $158Week 5. July 31- Aug 4 / $123Week 6. Aug 08-11 / $158 (No camp on Heritage day) Week 1. July 3-7 / $270Week 2. July 10-14 / $270Week 3. July 17-21 / $270Week 4. July 24-28 / $270Week 5. July 31- Aug 4 / $213Week 6. Aug 08-11 / $270 (No camp on Heritage day) Week 1. July 3-7 / $270Week 2. July 10-14 / $270Week 3. July 17-21 / $270Week 4. July 24-28 / $270Week 5. July 31-Aug 4 / $213Week 6. Aug 08-11 / $270 (No camp on Heritage day) Week 1. July 3-7 / $288Week 2. July 10-14 / $288Week 3. July 17-21 / $288Week 4. July 24-28 / $288Week 5. July 31-Aug 4 / $227Week 6. Aug 08-11 / $288 (No camp on Heritage day) After Early Bird Price Adjustment* $15 added per week 1 Weeks 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 Weeks Select the amount of weeks your child is registering Extended Care I don't need extended care Early Care and After Care Early Care Only After Care Only Extended Care AM Only 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM Only 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Extended Care AM 8:00am-9:00am Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $22Week 6: $18 Extended Care PM 3:30pm-5:00pm Week 1: $28Week 2: $28Week 3: $28Week 4: $28Week 5: $28Week 6: $24 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large Second Camp Tshirt $15.Camp Tshirts must be worn on all field trips. I don't need a second camp Tshirt Small (6-8) Medium (10-12) Large (14-16) Extra Large LUNCH and SNACKS and all TRIPS included in Registration price! Early Bird! Prices on until May 15th. After May 15th add $15 per week. Family Discount! 5% for each additional sibling. Refer A Friend Program! You and your friend receive $50 off camp tuition! _____________________________________________________________________ Next Section: Consent and Payment Section 3. Consent and Payment Emergency Medical Info I do hereby give permission to the Camp Gan Israel staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. However, In the event that we cannot reach you, who should we contact? Emergency Contact Name* First Name Last Name Relation to Child* Emergency Contact Phone Number* Area Code Phone Number Family Physician* First Name Last Name Physician Phone Number* Area Code Phone Number CGI Summer Day Camp Waiver PARENTAL CONSENT Parental consent for participation in all activities of CGI is fully implied unless specifically excluded during the registration process. DISMISSAL OF A CAMPER CGI reserves the right to dismiss, at its sole discretion, any camper whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interests of CGI or fellow campers or who violates CGI rules and regulations, in which case no refunds will be made. MEDICAL CARE/ Emergency Medical Treatment In the event of an emergency, serious illness, or accident, CGI has permission to arrange for any necessary first-aid or care by a licensed physician for any child/ren attending camp. Every effort will be made to contact the parent/guardian and emergency contacts first. Should it be necessary for the well-being of the camper to utilize outside medical or dental services all expenses involved will be paid for by the parent. Parents are required to notify CGI in a timely manner of any infectious diseases or infestations acquired by a camper during their participation at camp. IMAGES & PHOTO RELEASE. Permission is hereby given for CGI and Chabad to use in promoting CGI and in other ventures directly relating to the CGI including the Chabad Facebook page & Instagram page (i) digital, photographic, video, and audio images or likenesses of camper; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by Camper or originating from CGI or from a CGI related activity. INDEMNIFY AND HOLD HARMLESS I agree to indemnify and hold harmless CGI, Chabad, and its officers, employees, volunteers or assigns from any liability concerning my child’s involvement in CGI and further agree that the use of any premises during the program is made at my own risk. ACKNOWLEDGEMENT By typing my name below as a signature for this agreement, I certify that I have legal capacity to act as the parent/guardian of the named minor. I further understand that this form and the terms of this agreement are legally binding and certify that I am signing this agreement, after having carefully read it, of my own free will. Parent or Legal Guardian Signature* Type your name here Date* Month Day Year at 1 2 3 4 5 6 7 8 9 10 11 12 Hour 00 10 20 30 40 50 Minutes AM PM Payment Information Payments are manually processed. Any sibling discounts (ie 5% off additional sibling registrations) and/or Refer A Friend Program discounts (ie $50 off) will be adjusted for before the payment is processed. I'd like to donate to the Camp Scholarship Fund I'd like to choose one of the suggested amounts from the drop down Thank you! Select amount $36 $72 $101 $180 $360 $540 Total $0.00 CAD Payment* Credit Card Cheque, Cash or Etransfer Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 Expiration Year Cheques are to be made payable to Chabad Lubavitch of Alberta Etransfer to [email protected] Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Joining Camp Gan Israel is not an acknowledgment of Halachic Jewish Status Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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