12/13/2022 Uncategorized by Mushka Osdoba Camp Registration 2023 "*" indicates required fields Camper InformationProgram Choice* Mini Gan (entering: Toddler – Prek) Junior Gan (entering: Kindergarten-1st Grade) Gan Izzy (entering: 2nd-6th Grade) JCC Camp (entering: 4th-7th Grade) Teen Camp (entering: 7th-10th Grade) Mini Gan Name Dates Attending | $495 per week Total Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Junior Gan Name Dates Attending | $450 per week Total Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Gan Izzy Name Dates Attending | $450 per week Total Actions Edit Delete There are no Children. Add Child Maximum number of children reached. JCC CampJuly 10 – August 17, 2023 Name Dates Attending | $450 per week Total Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Teen CampJuly 17 – August 10, 2023 Name Dates Attending | $750 per week Total Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Total Registration Cost Price: $0.00 Family InformationHome Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parent 1*NameCell PhoneEmailParent 2*NameCell PhoneEmailEmergency Contact*Please provide 1 emergency contacts besides parents.Last NameFirst NameRelationship to childPhoneEmail Add RemoveTransportation Please note there is NO TRANSPORTATION FOR TEEN CAMPNumber of kids requiring bussingNo Transportation1 child2 children3 children4 childrenChild 1 | $50 per week* Numer of transportion weeks Quantity* Price: $50.00 Quantity Child 2 | $30 per week* Numer of transportion weeks Quantity* Price: $30.00 Quantity Child 3 | $15 per week* Numer of transportion weeks Quantity* Price: $15.00 Quantity Child 4 | Free* Numer of transportion weeks Quantity* Price: $0.00 Quantity Transportation Total $0.00 Consent & PaymentTerms and Conditions* I, the undersigned agree, understand and authorize the amount shown above to be charged to my credit card for the items shown on the referenced order. I understand these charges will appear on my credit card statement under my name and I accept full financial responsibility for payment of this order. Registration will be completed with an acceptance letter within 2-3 business days. All payments are non-refundable. Medical forms & Immunization forms must be submitted to camp by May 1st (easiest way is for your Dr’s office to email info@CampCGI.com) Email*By entering your email you are accepting the terms above Your Name* First Last Optional MessagePaymentRegistration Fee per familyPayment* I understand that my bill has to be settled with the financial office before June 12th for my child(ren) to enter camp on day 1. Only Children with an entrance ticket will be allowed in. Registration CostTotal of all children registered $0.00 TransportationTotal cost $0.00 Registration FeeMandatory fee per family $0.00 CouponHave a coupon code? Enter below: Total HiddenPayment Options* Pay in full $750 deposit Payment Options* Pay in full DepositYour card will be charged $750 upon submission. The next payment installment will be due in March (remaining amount must be paid in full by 6/12/2023). Price: Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Δ
