Camper Registration | www.ganisraelberkeley.com

If you have previously registered and are looking to pay or are just looking to donate click here.

Mother's Info

First Name *

Last Name *

Phone Number *

Email *

Street Address *

City *

Postal Code *

State/Province *

Father's Info

First Name *

Last Name *

Phone Number *

Email *

Share address of

Address is same as Mother's

Street Address *

City *

Postal Code *

State/Province *

How many children are you registering? *

Camper

First Name *

Last Name *

Gender *

Birth Date *

Month

Day

Year

Shirt Size *

Select Group *

You have the same address as:

Street Address *

City *

Postal Code *

State/Province *

Main Camp Sessions ($320/week)

Week 1 - June 29th, 2020 - July 3rd, 2020

Week 2 - July 6th, 2020 - July 10th, 2020

Week 3 - July 13th, 2020 - July 17th, 2020

Week 4 - July 20th, 2020 - July 24th, 2020

Full Summer Discount $

Health Info

Health Insurance Name *

Health Insurance Number *

Name any Allergies

List any medical conditions we should be aware of

Emergency Contact Info

First Name *

Last Name *

Cell Number *

Work Number *

Email *

Camper 2

First Name *

Last Name *

Gender *

Birth Date *

Month

Day

Year

Shirt Size *

Select Group *

You have the same address as:

Street Address *

City *

Postal Code *

State/Province *

Main Camp Sessions ($320/week)

Week 1 - June 29th, 2020 - July 3rd, 2020

Week 2 - July 6th, 2020 - July 10th, 2020

Week 3 - July 13th, 2020 - July 17th, 2020

Week 4 - July 20th, 2020 - July 24th, 2020

Full Summer Discount (Camper 2) $

Health Info

Health Insurance Name *

Health Insurance Number *

Name any Allergies

List any medical conditions we should be aware of

Emergency Contact Info

First Name

Last Name

Cell Number

Work Number

Email

Camper 3

First Name *

Last Name *

Gender *

Birth Date *

Month

Day

Year

Shirt Size *

Select Group *

You have the same address as:

Street Address *

City *

Postal Code *

State/Province *

Main Camp Sessions ($320/week)

Week 1 - June 29th, 2020 - July 3rd, 2020

Week 2 - July 6th, 2020 - July 10th, 2020

Week 3 - July 13th, 2020 - July 17th, 2020

Week 4 - July 20th, 2020 - July 24th, 2020

Full Summer Discount (Camper 3) $

Health Info

Health Insurance Name *

Health Insurance Number *

Name any Allergies

List any medical conditions we should be aware of

Emergency Contact Info

First Name

Last Name

Cell Number

Work Number

Email

Camper 4

First Name *

Last Name *

Gender *

Birth Date *

Month

Day

Year

Shirt Size *

Select Group *

You have the same address as:

Street Address *

City *

Postal Code *

State/Province *

Main Camp Sessions ($320/week)

Week 1 - June 29th, 2020 - July 3rd, 2020

Week 2 - July 6th, 2020 - July 10th, 2020

Week 3 - July 13th, 2020 - July 17th, 2020

Week 4 - July 20th, 2020 - July 24th, 2020

Full Summer Discount (Camper 4) $

Health Info

Health Insurance Name *

Health Insurance Number *

Name any Allergies

List any medical conditions we should be aware of

Emergency Contact Info

First Name

Last Name

Cell Number

Work Number

Email