Registration Part 2 Summer Day Camp 2024

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Gan Izzy Day Camp Registration - Part Two
A day camp for Jewish children, celebrating our traditions.
1) After submitting part 1 registration for your child for camp, please submit this form before May 15th.

2) This form is per a camper. If you have more than one child participating in Gan Izzy this summer, you will need to complete this form per child.

3) Please upload your chlid's medical form, before June 1st to www.ganizzy.info/forms

Click here to download the health form
Camper Information
Camper's Name*

First Name Last Name
Parent email address*
Emergency Contact Information.

When parent is not available
Emergency Contact Name*

First Name Last Name
Relationship To Child*
Emergency contact Phone Number*

Area Code Phone Number
Child Health Information
Pediatrician Name*

First Name Last Name
Pediatrician Phone Number*

Area Code Phone Number
Does your child have allergies?*

YesNo
If yes, please specify what your child is allergic to, and any medications:
Friend Request (optional)
Is there a friend your child would like to be in the same bunk with?*

YesNo
While we make every effort to accommodate each camper’s request, we can’t guarantee that your child will be with the friend they have chosen.
Friend request

Friend 1 Friend 2
Pre/After Care
Precare from 8am - $6 per day when paid in advance per week. Pay as you go, daily $7
Aftercare until 4:30pm -$6 per day when paid in advance per week. Pay as you go, daily $7
until 5:30pm - $12 per day when paid in advance per week. Pay as you go, daily $14
Would you like Pre-Care for your child*

NoYes, pay in advance per week - $6 per dayYes, pay as you go - $7 per day
Please select the weeks to prepay for Precare

Week 1 June 24 - June 28Week 2 July 1 - July 5Week 3 July 8 -July 12Week 4 July 15 - July 19Week 5 July 22 - July 26
Would you like After-Care for your child*

NoYes, pay in advance for aftercare. Until 4:30pm - $6 or until 5:30pm - $12 per dayYes, pay as you go until 4:30pm - $7 a dayYes, pay as you go until 5:30pm - $14 a day
Please select until what time and which weeks you would like to prepay for Aftercare

4:30pm - Week 1 June 24 - June 284:30pm - Week 2 July 1 - July 54:30pm - Week 3 July 8 - July 124:30pm - Week 4 July 15 - July 194:30pm - Week 5 July 22 - July 265:30pm - Week 1 June 24 - June 285:30pm - Week 2 July 1 - July 55:30pm - Week 3 July 8 - July 125:30pm - Week 4 July 15 - July 195:30pm - Week 5 July 22 - July 26
Transportation (Additional Fee)
Door to door transportation is full from certain areas. Please contact the camp office before choosing the door to door option to see if there is available space on the route in your area.

Transportation provided from most locations, for an additional fee. Please call 215 497 9925 Ext. 3 or email [email protected] to see if we offer busing from your area.

General Pick Up is $40 a week

Before May 15th - Door to door option $70 a week for the first child, $40 per an additional child.
After May 15th- Door to door option $85 a week for the first child, $40 per an additional child.
Would you like bus transportation for your child?

NoYes, $40 a week - General Pickup or second child door to doorYes, $85 a week - Door to Door
Please select which weeks you will need bus transportation - $40 a week.

Week 1 June 24 - June 28Week 2 July 1 - July 5Week 3 July 8 -July 12Week 4 July 15 - July 19Week 5 July 22 - July 26
Door to Door Transportation - $85 a week. Please indicate which weeks you will need bus transportation

Week 1 June 24 - June 28Week 2 July 1 - July 5Week 3 July 8 -July 12Week 4 July 15 - July 19Week 5 July 22 - July 26
T-shirts - $12 each
It is mandatory to wear a camp T-shirt on trip days. Therefore, we recommend a minimum of 2 T-shirts. The cost for each T-shirt is $12
How Many T-shirts Would You Like To Purchase?*
Select the camp T-shirt size
Optional camp Gan Izzy SWIM SHIRTS
The cost for each swim shirt is $23
How Many Swim Shirts Would You Like To Purchase?
Select the swim shirt size
Total

$0.00
In order to create an effective and positive camp environment for everyone, please provide the information about your child. All information will be handled with care and held in confidence:
Does your child have an IEP or 504 Plan?*

YesNo
Please upload your child's IEP or 504 at www.ganizzy.info/forms
Please select any of the items that apply to your child

Has a short attention spanIs overly activeIs very sensitive/upsets easilyHas social challengesHas emotional challengesHas medical challengesHas special needs/disabilitiesHas a learning disability
Please share more information about specific challenges here
Please share any information that may affect performance or behavior while in camp
Please share any tools and strategies that benefit your child in your home or school that we might incorporate into the camp environment
How did you hear about Gan Izzy?

Returning CamperFriend or Family MemberEmailSocial Media
Click here to download your child's health form.
Please upload your child's health form before June 1st at www.ganizzy.info/forms
Parental Consent
Parental Consent*

I permit my child to participate in all activities of Gan Izzy Day Camp - on site, off site and trips.I give permission for Gan Izzy Day Camp to photograph my child and use the photos in brochures, and for all promotional purposes.I will upload my child/rens health form by June 1stI understand that my child may be dismissed due to illness, at the discretion of the camp, and I agree to abide by the director's decision.The parent who signs this registration form represents that he/she has full authority to do so, and will be responsible for payment of the camp fees.

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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Gan Izzy Day Camp Registration - Part Two

A day camp for Jewish children, celebrating our traditions.

Camper Information

Emergency Contact Information.

Child Health Information

Friend Request (optional)

Pre/After Care

Transportation (Additional Fee)

T-shirts - $12 each

Parental Consent