Winter Registration 2016 | Ganeinu Day Camp

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Winter Registration 2016

Summer Camp 2018 June 25 - July 27

Trip Camp July 30 - August 3

Ganeinu Open House Sunday, June 24

Winter Camp 2016 Registration is Closed.
Please Call Tzippy: 248-470-6881

Camper/Parent Information
Child 1 Name	First	Middle	Last
DOB	Age:
Child 2 Name	First	Middle	Last
DOB	Age:
Child 3 Name	First	Middle	Last
DOB	Age:
Address	Street	City	State, Zip
Contact Info	Phone	Email
Schools	School	Hebrew School	Grade:
Child's Mother	Mother's Name	Work Phone	Cell
Child's Father	Father's Name	Work Phone	Cell
Emergency Contact Info	Name	Phone	Relationship
Pediatrician	Name	Phone
Email

Winter Camp Fees & Dates:

Fees	$200 Full Week $50 a Day
Camp Dates	10:00am - 4:00pm Please check the days that your child will be attending: Monday, December 26 Tuesday, December 27 Wednesday, December 28 Thursday, December 29 Friday, December 30 (Early dismissal: 2:00 PM) Extended hours: ($5 an hour) 8:00AM - 10:00AM Mon Tues Wed Thurs Fri 4:00PM - 6:00 PM Mon Tues Wed Thurs Fri Camp T-shirt - $10 (mandatory) Note: Please complete the camp lunch form for meal requests. Thank you!
Payment and agreements
•	All forms must be completed and submitted for the Winter Camp in order to secure a place for your child.
•	Credit Card Number Exp CVV If the billing address does not match address above, please fill it out in the comments section below. Promo Code: Total $ (including T-shirt)
	I have read the camp brochure and application form and agree to the terms stated. I give my child permission to attend all trips, and receive medical care in the case of emergency. Also, I give FREE Winter Camp permission to photograph and videotape my children and use the photos and videos for whatever the camp sees fit.
	Print name of parent filling out form
After you form is complete please fill out the lunch form. Comments:

Summer: 4230 Middlebelt Road • West Bloomfield, MI 48323 • 248-470-6881 Winter: 5595 W Maple Rd, West Bloomfield, MI 48322 • 248-470-6881
A branch of the world's largest Jewish Camping network, Camp Gan Israel International