Gan Izzy Summer 2018 Enrollment is now OPEN!!
Gan Izzy Winter Fun Days will be on December 30 & 31.
Ages 3+ (potty trained)
9:30 am - 3:00 pm
First Name: Last Name: Hebrew Name:
Birthdate: Current Age:
Hebrew Birthdate (if known):
Current School: Grade for 2014-2015:
Please list any allergies or medical information that needs to be shared about your child:
Home Address: City/State/Zip:
Mother's First Name: Mother's Last Name:
Mother's Hebrew Name:
Father's First Name: Father's Last Name:
Father's Hebrew Name:
Contact and Emergency Information:
Email Address For Camp Related Information:
Home Phone Number:
Mother's Cell Phone Number: Mother's Work Number:
Father's Cell Phone Number: Father's Work Number:
Emergency Contact: Relationship to Camper:
Phone Number For Emergency Contact:
Please indicate who we should call first if we need to reach you:
Please indicate which sessions your child will be attending:
$18 per day when paid and registered by Decemeber 7. Price goes to $36 per day on December 8.
I will pay online wit a credit card (must pay by Dec 7 to get special sale price)
I will mail a check to 1920 Colley Avenue, Norfolk, VA 23517
Credit Card Information:
Name as it appears on card:
Billing zip code for card: Type of Card:
Card Number: Expiration: CV Code:
I authorize Chabad of Tidewater to charge my card in the amount of .
Thank you for enrolling in Camp Gan Israel - we can't wait to see you in camp!