(Scholarship applicants must also complete the Scholarship Application )Parent's InformationParent's Status*MarriedWidowedDivorcedSeparatedHome Phone*Area CodePhone NumberHome Address*Street AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryMother's Full Name*First NameLast NameMother's Cell Number*Area CodePhone NumberMother's E-mail*Father's Full Name*First NameLast NameFather's Cell Number*Area CodePhone NumberFather's E-mail*Is the Child(ren)'s Mother Jewish?*YesNoHave there been any conversions or adoptions in the family?*YesNoIf yes, please elaborateNumber of Children being registered*Camper 1 InformationFull Name*First NameLast NameHebrew NameBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGender*School Attending*Entering Grade*Camper 2 Information#2 Full NameFirst NameLast Name#2 Hebrew Name#2 Birth Date1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Year#2 Gender#2 School Attending#2 Entering GradeCamper 3 Information#3 Full NameFirst NameLast Name#3 Hebrew Name#3 Birth Date1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Year#3 Gender#3 Attending School#3 Entering GradeEmergency Contact InformationContact 1 Full Name*First NameLast NameContact 1 Phone Number*Area CodePhone NumberContact 1 Relationship to Child*Contact 2 Full NameFirst NameLast NameContact 2 Phone NumberArea CodePhone NumberContact 2 Relationship to ChildFamily Physician*Physician Phone Number*Area CodePhone NumberAre there any medical concerns that our staff should be aware of?*General InformationPrevious Camp(s) AttendedHow did you hear about Camp Gan Israel?*What goals would you like to see your child/ren accomplish during camp?Briefly describe your child/ren's personality*Briefly describe your child/ren's favorite activities*Permissions*I hereby give permission for my child to participate in all Camp Gan Israel activities and trips.I also hereby consent that the administration of Camp Gan Israel may take whatever medical measures they deem necessary for my child, in the event of an emergency.I also authorize Camp Gan Israel to have and use photographs, slides and videos of the person/s named on this application as needed, for educational and public relations programs.Tuition InformationA sibling refund of 10% per child, will be applied to the highest tuition per family.Child 1 Camp Options*Mini Gan Half Day One Week - $200Mini Gan Half Day Two Weeks - $400Mini Gan Half Day Full Session - $550Mini Gan Full Day One Week - $250Mini Gan Full Day Two Weeks - $500Mini Gan Full Day Full Session - $675Older Division One Week - $250Older Division Two Weeks - $500Older Division Full Session - $675CITs One Week - $200CITs Two Weeks - $400CITs Three Weeks - $590Child 2 Camp OptionsMini Gan Half Day One Week - $200Mini Gan Half Day Two Weeks - $400Mini Gan Half Day Full Session - $550Mini Gan Full Day One Week - $250Mini Gan Full Day Two Weeks - $500Mini Gan Full Day Full Session - $675Older Division One Week - $250Older Division Two Weeks - $500Older Division Full Session - $675CITs One Week - $200CITs Two Weeks - $400CITs Three Weeks - $590Child 3 Camp OptionsMini Gan Half Day One Week - $200Mini Gan Half Day Two Weeks - $400Mini Gan Half Day Full Session - $550Mini Gan Full Day One Week - $250Mini Gan Full Day Two Weeks - $500Mini Gan Full Day Full Session - $675Older Division One Week - $250Older Division Two Weeks - $500Older Division Full Session - $675CITs One Week - $200CITs Two Weeks - $400CITs Three Weeks - $590Child 3 Camp OptionsMini Gan Half Day One Week - $225Mini Gan Half Day Two Weeks - $450Mini Gan Half Day Full Session - $495Mini Gan Full Day One Week - $275Mini Gan Full Day Two Weeks - $550Mini Gan Full Day Full Session - $595Older Division One Week - $275Older Division Two Weeks - $550Older Division Full Session - $595CITs One Week - $275CITs Two Weeks - $550CITs Three Weeks - $595Child 2 Camp OptionsMini Gan Half Day - $175/week, $450 for entire sessionMini Gan Full Day - $225/week, $595 for entire sessionOlder Division - $225/week, $595 for entire sessionCITs - $150/weekChild 3 Camp OptionsMini Gan Half Day - $175/week, $450 for entire sessionMini Gan Full Day - $225/week, $595 for entire sessionOlder Division - $225/week, $595 for entire sessionCITs - $150/weekMy child(ren) will be attending:*Week 1: Monday, June 26- Friday, June 30Week 2: Monday, July 3 - Friday, July 7Week 3: Monday, July 10- Friday, July 14Full Session: June 26 - July 14Child 1 T-shirt Size ($20/each)Child SChild MChild LAdult SAdult MAdult LChild 2 T-shirt Size ($20/each)Child SChild MChild LAdult SAdult MAdult LChild 3 T-shirt Size ($20/each)Child SChild MChild LAdult SAdult MAdult LI would like for CGI to provide lunch ($30/week):Child 1 Lunch selection:1 Week2 Weeks3 WeeksChild 2 Lunch selection:1 Week2 Weeks3 WeeksChild 3 Lunch selection:1 Week2 Weeks3 WeeksQuestions / Comments$36 Registration per Child is due upon Registration. Please indicate when you would like the balance charged.I would love to share the Jewish camp experience with another family, by contributing to the Camp Scholarship Fund!$Total$0.00I would like to pay today: Full amount$72.00 minimum $ PaymentBalance may be paid by checkCredit Card Paypal Credit CardWe accept Visa, MasterCard, American Express, DiscoverCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2023202420252026202720282029203020312032Expiration YearPaypal has been selected. Payment will take place on the next page.Billing AddressStreet AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryHow did you hear about us?Submit100% of the proceeds of this donation or payment benefit Chabad of The Woodlands.Should be Empty: This page uses TLS encryption to keep your data secure.