Jkids End of Summer Camp

Price per Camper is $200 (Lunch and snack included)
(Early Bird Price $175 until June 18)
A $50 non-refundable deposit per child is due in order to reserve a spot for your child. This amount will be applied to your final tuition cost. Your application cannot be accepted without this deposit.

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail

Parent 1 Full Name*

First Name Last Name

Parent 1 Phone Number*

Parent 2 Full Name

First Name Last Name

Parent 2 Phone Number

Is Parent 1 Jewish?*

Is Parent 2 Jewish?*

How many children are you interested in registering?

Child 1 Name *

First Name Last Name

Child 1 Hebrew Name*

Birth Date*

Month Day Year

Gender*

MaleFemaleN/A

Current School*

What grade would the child be entering by Sept 2025?*

T-shirt Size* Camp T-shirts must be worn on all trip days. One camp t-shirt is included with your camp fee. Additional t-shirts are available at $10/t-shirt.

Do you need extended care? (3:30-5pm) Additional $100 for the week.

Does your child have any allergies or dietary restrictions? If yes, Please explain.*

Does your child have any health issues that we need to know about? If yes, Please explain.*

Child 2 Name*

First Name Last Name

Child 2 Hebrew Name*

Birth Date*

Month Day Year

Gender*

MaleFemaleN/A

Current School*

What grade would the child be entering by Sept 2025?*

T-shirt Size* Camp T-shirts must be worn on all trip days. One camp t-shirt is included with your camp fee. Additional t-shirts are available at $10/t-shirt.

Do you need extended care? (3:30-5pm) Additional $100 for the week.

Does your child have any allergies or dietary restrictions? If yes, Please explain.*

Does your child have any health issues that we need to know about? If yes, Please explain.*

Child 3 Name

First Name Last Name

Child 3 Hebrew Name

Birth Date

Month Day Year

Gender

MaleFemaleN/A

Current School

What grade would the child be entering by Sept 2025?

T-shirt Size* Camp T-shirts must be worn on all trip days. One camp t-shirt is included with your camp fee. Additional t-shirts are available at $10/t-shirt.

Do you need extended care? (3:30-5pm) Additional $100 for the week.

Does your child have any allergies or dietary restrictions? If yes, Please explain.*

Does your child have any health issues that we need to know about? If yes, Please explain.*

Child 4 Name*

First Name Last Name

Child 4 Hebrew Name*

Birth Date*

Month Day Year

Gender*

MaleFemaleN/A

Current School*

What grade would the child be entering by Sept 2025?*

T-shirt Size* Camp T-shirts must be worn on all trip days. One camp t-shirt is included with your camp fee. Additional t-shirts are available at $10/t-shirt.

Do you need extended care? (3:30-5pm) Additional $100 for the week.

Does your child have any allergies or dietary restrictions? If yes, Please explain.*

Does your child have any health issues that we need to know about? If yes, Please explain.*

Child 5 Name*

First Name Last Name

Child 5 Hebrew Name*

Birth Date*

Month Day Year

Gender*

MaleFemaleN/A

Current School*

What grade would the child be entering by Sept 2025?*

T-shirt Size* Camp T-shirts must be worn on all trip days. One camp t-shirt is included with your camp fee. Additional t-shirts are available at $10/t-shirt.

Do you need extended care? (3:30-5pm) Additional $100 for the week.

Does your child have any allergies or dietary restrictions? If yes, Please explain.*

Does your child have any health issues that we need to know about? If yes, Please explain.*

Child 6 Name*

First Name Last Name

Child 6 Hebrew Name*

Birth Date*

Month Day Year

Gender

MaleFemaleN/A

Current School

What grade would the child be entering by Sept 2025?

T-shirt Size* Camp T-shirts must be worn on all trip days. One camp t-shirt is included with your camp fee. Additional t-shirts are available at $10/t-shirt.

Do you need extended care? (3:30-5pm) Additional $100 for the week.

Does your child have any allergies or dietary restrictions? If yes, Please explain.*

Does your child have any health issues that we need to know about? If yes, Please explain.*

While we are currently only offering the week of Aug 25 - Aug 30, we are exploring interest if we should additionally offer the Week of Aug 18 - Aug 22. If interested please check which days in that add week interest you

Pediatrician*

Pediatrician Phone Number*

In case of emergency and we are unable to contact a parent, please write an individual that can be contacted.

Emergency Contact*

Emergency Contact Phone Number*

Emergency Contact Relationship to Child*

Total

$0.00

I would like to pay today:Full amount28.5714% minimum: $0.00 $

Payment

Credit Card Paypal

Postal / Zip Code

Country

As the parent(s) or legal guardian(s) of child noted above, I/we authorize any adult acting on behalf of the Camp Gan Israel of Greenville/Chabad of Greenville, to hospitalize or secure treatment for my child. I further agree to pay for all charges for that care and/or treatment. It is understood that, if time and circumstances reasonably permit, the camp will try to communicate with me prior to such treatment. As parents/guardians, we agree that we will be responsible for any loss, damage or destruction by our camper to any property of Camp Gan Israel or to any property for which the camp is liable or chargeable. I/we hereby give permission for my child to attend all field trips and outings sponsored by the Camp Gan Israel of Greenville/Chabad of Greenville and be transported to and from the field trips and outings. I also allow my child to be photographed/videod while participating in camp activities. I/we understand that these photographs/videos may be used for publicity purposes. Please date and sign.

Please type your signature here*

Today's Date*

Month Day Year

Comments

I would like to receive news and updates by email

J Ki ds

Family Information

Camper 1 Information

Camper 2 Information

Camper 3 Information

Camper 4 Information

Camper 5 Information

Camper 6 Information

Medical/Emergency Information

Payment Information