Welcome to Jewish Kids Club, Gan Israel Summer Program 2019
Online Quick Registration!

Please fill out the form below carefully. There is a $50.00
non-refundable registration fee, per child, that will be applied toward the Gan Israel summer program tuition. When you press submit, this form will be sent to our administration office.

Note: Please use a separate form for each child. If you would like to register more then one child, hit the back button after you submit the form and change the necessary information.

Please be sure to download the comprehensive Registration/ Medical form from our site.  Print it, complete it, and mail it to us.  All forms must be completed and submitted before your child begins the summer program.

Basic Camper/Parent Information
Name

 

First
Hebrew Name
Last
Male 
Female
Address
  Street
City
State
Zip
Date of Birth
  Age : 
Contact Info
  Home Phone
Father Email
Mother Email
 
Schools
  School
Current Grade:
Child's Mother
  Mother's Name
Hebrew Name
Work Phone
Cell
Child's Father
  Father's Name
Hebrew Name
Work Phone
Cell
     Emergency
 Contact Info
  Name
Phone
Relationship
 
    T-Shirt Size
  Child Size: 6-8, 10-12, 14-16 
Adult: Small, Med, Large 
   
Referred By
     
           
 
Select a payment option
Charge my card now for the non-refundable registration fee of $50 and I will submit the balance via charge card by July 15, 2019.
I will mail a check for the non-refundable registration fee of $50 now, and I will send the balance by July 15, 2019.  
Charge my card now for the full tuition due
I will send you a check for the complete balance.  
 
 
Please indicate which weeks your child will attend camp:

Full Session  Week 1   Week 2

     
IMPORTANT
All forms must be completed and submitted before your child begins the summer program.  Be sure to download the comprehensive Registration/ Medical Form from our site.  Print it, complete it, and return it to us by July 15, 2019.
 
 
 
 
 
 
 

I hereby register my child in the Jewish Kids Club, Gan Israel Summer Program and give permission for my child to participate in all activities, including trips. I understand that Jewish Kids Club does not assume responsibility for any injury, and in case of emergency, necessary medical attention may be secured by the administration. A medical form will be sent to you after registration.

After you submit this form you will have the opportunity to pay the $50.00 registration fee on-line at www.chabadcapecod.com/donate.

   
  Date of Application: