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Pre-Registration Form

Pre-Registration Form

2017 Camp Gan Israel Pre‐Registration Form

A $50 deposit must accompany pre‐registration. This will be deducted from the camp tuition, but is not refundable.
Check can be mailed to: Camp Gan Israel, 7400 Falls of the Neuse Rd., Raleigh, NC 27615
Upon receipt, we will send you the registration and medical forms.

Please complete this form in full and click submit below:

Child 1:
Camper's name: Gender: Male Female
Birth date: Age:
Grade entering: School attended:
Weeks attending: 1st: 2nd: 3rd: 4th: All:
Child 2:
Camper's name: Gender: Male Female
Birth date: Age:
Grade entering: School attended:
Weeks attending: 1st: 2nd: 3rd: 4th: All:
Child 3:
Camper's name: Gender: Male Female
Birth date: Age:
Grade entering: School attended:
Weeks attending: 1st: 2nd: 3rd: 4th: All:
Parent Information
Name Address
City/State/Zip Home Phone
Email Cell Phone
Business Phone    

Additional Information:

Registration Payment Information
Credit Card Type Credit Card Number
Exp Date CVV
Amount to Charge    

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