Welcome to Camp Gan Israel RegistrationCGI 2023 Summer Camp Hosts Ben & Diane Docktor Lunch and snacks are included!At no extra cost. Family discount!5% off for each additional sibiling. Refer a friend program!You and your friend will receive a $50 tuition credit. Section 1. Family Information Father's Full Name* Father's First Name Father's Last Name Father's Mobile Number* Area Code Phone Number Father's E-mail* Mother's Full Name* Mother's First Name Mother's Last Name Mother's Mobile Number* Area Code Phone Number Mother's E-mail* Home Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther 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 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child One Gender* MaleFemale Child One School Attending* Child One Grade Finishing in 2022* Child One Alberta Health* Camp Sessions Age group* Please selectKiddie 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 Kiddie Camp Full Day (Ages 3 or 4) Week OneFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210Not Attending July 3-7 Week TwoFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210Not Attending July 10-14 Week ThreeFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210Not Attending July 17-21 Week FourFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210Not Attending July 24-28 Week FiveFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210Not Attending July 31 - Aug 4 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) Kiddie Camp Full Day Ages 4 Only Week 1. July 3-7 / $270Week 2. July 10-14 / $270Week 3. July 17-21 / $270Week 4. July 24-2 / $270Week 5. July 31- Aug 4 / $213Week 6. Aug 08-11 / $270 (No camp on Heritage day) Day Camp Kindergarten to Grade 3 Ages 5 & Up 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) Day Camp Grade 4 & Up 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 Weeks2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks Select the amount of weeks your child is registering Additional Options Extended Care I don't need extended careEarly Care and After CareEarly Care OnlyAfter Care Only Extended Care AM 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Extended Care AM Only 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM Only 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp TshirtSmall (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 TshirtSmall (6-8)Medium (10-12)Large (14-16)Extra Large LUNCH and SNACKS included in Registration price! Early Bird! Prices on until April 28th. After April 28th 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 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child Two Gender* MaleFemale Child Two School Attending* Child Two Grade Finishing in 2022* Child Two Alberta Health* Camp Sessions Age Group* Select campers age groupKiddie 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 Kiddie Camp Full-Day (Ages 3-4) Week One / July 3-7 Select an option to registerFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210 Week Two - July 10-14 Select an option to registerFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210 Week Three, July 17-21 Select an option to registerFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210 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) Kiddie Camp Full Day Ages 4 Only 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 8-11 / $270 (No camp on Heritage day) Day Camp Kindergarten to Grade 3 Ages 5 & Up 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) Day Camp Grade 4 & Up 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 Weeks2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks Select the amount of weeks your child is registering Additional Options Extended Care I dont need extended careEarly Care and After CareEarly Care OnlyAfter Care Only Extended Care AM Only 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM Only 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Extended Care AM 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp TshirtSmall (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 TshirtSmall (6-8)Medium (10-12)Large (14-16)Extra Large LUNCH and SNACKS included in Registration price! Early Bird! Prices on until April 28th. After April 28th 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 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child Three Gender* MaleFemale Child Three School Attending* Child Three Grade Finishing in 2022* Child Three Alberta Health* Camp Sessions Select Sessions for Child 3* Select campers age groupKiddie 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 Select Rate Options for Kiddie Camp HDFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210 Select Rate Options for Kiddie Camp FDFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210 Select Rate Options for Kindergarten to Grade 3Full (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210 Select Rate Options for Grade 3 and upFull (Cost Rate) $350Standard (Affordable Rate) $285Subsidized (Scholarship Rate) $210 1 Week 1. July 3-7 / $158Week 2. July 10-14 / $158Week 3. July 17-21 / $158Week 4. July 24-28 / $158Week 5. Aug 2-5 / $123Week 6. Aug 08-11 / $158 (No camp on Heritage day) 2 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) 3 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) 4 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) 5 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) 6 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) 7 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) 8 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) 9 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 Weeks2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks Select the amount of weeks your child is registering Additional Options LUNCH and SNACKS included in Registration price! Early Bird! Prices on until April 28th. After April 28th 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 careEarly Care and After CareEarly Care OnlyAfter Care Only Extended Care AM Only 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM Only 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Extended Care AM 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp TshirtSmall (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 TshirtSmall (6-8)Medium (10-12)Large (14-16)Extra Large _____________________________________________________________________ Next: Add Another ChildSkip to Consent and Payment Child Four Full Name* First Name Last Name Child Four Hebrew Name* Child Four Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child Four Gender* MaleFemale Child Four School Attending* Child Four Grade Finishing in 2022* Child Four Alberta Health* Age group* Select campers age groupKiddie 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 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) Kiddie Camp Full Day Ages 4 Only 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) Day Camp Kindergarten to Grade 3 Ages 5 & Up 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) Day Camp Grade 4 & Up 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 Weeks2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks Select the amount of weeks your child is registering Extended Care I don't need extended careEarly Care and After CareEarly Care OnlyAfter Care Only Extended Care AM Only 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM Only 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Extended Care AM 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp TshirtSmall (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 TshirtSmall (6-8)Medium (10-12)Large (14-16)Extra Large LUNCH and SNACKS included in Registration price! Early Bird! Prices on until April 28th. After April 28th 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 Full Name* First Name Last Name Child Five Hebrew Name* Child Five Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Child Five Gender* MaleFemale Child Five School Attending* Child Five Grade Finishing in 2022* Child Five Alberta Health* Age group* Select campers age groupKiddie 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 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) Kiddie Camp Full Day Ages 4 Only 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) Day Camp Kindergarten to Grade 3 Ages 5 & Up 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) Day Camp Grade 4 & Up 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 Weeks2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks Select the amount of weeks your child is registering Extended Care I don't need extended careEarly Care and After CareEarly Care OnlyAfter Care Only Extended Care AM Only 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM Only 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Extended Care AM 8:00am-9:00am Week 1: $20Week 2: $20Week 3: $20Week 4: $20Week 5: $18Week 6: $20 Extended Care PM 3:30pm-5:00pm Week 1: $22Week 2: $22Week 3: $22Week 4: $22Week 5: $20Week 6: $22 Camp Tshirt $15.Camp Tshirts must be worn on all field trips. My child has a Camp TshirtSmall (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 TshirtSmall (6-8)Medium (10-12)Large (14-16)Extra Large LUNCH and SNACKS included in Registration price! Early Bird! Prices on until April 28th. After April 28th 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 Medical Treatment ConsentI 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. Emergency Medical Consent* YesNo In the event we cannot be reached, please 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 Photo Release ConsentI do hereby permit the use of pictures and videos that may have my child in them for Chabad and Camp Gan Israel's website, social media, and publications. Photo Release Consent* YesNo Parent or Legal Guardian* Payment InformationPayments 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. 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 Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2023202420252026202720282029203020312032 Expiration YearCheques are to be made payable to Chabad Lubavitch of AlbertaEtransfer to [email protected]Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Joining Camp Gan Israel is not an acknowledgment of Halachic Jewish Status Double-click to edit this text... 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