Child #1

Camper #2

Camper #3

Camper #4

In case of an emergency, and we are unable to contact a parent, please call:

CONSENT FOR EMERGENCY MEDICAL TREATMENT: I do hereby give permission to the Gan Israel Day Camp staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible

1. Completed application and additional medical forms must be signed and returned prior to camp, otherwise your child/ren will not be allowed in to camp. This is the law and we cannot make any exceptions. 2. PARENTAL CONSENT: I hereby give consent for my child to participate in all activities of Camp Gan Israel (CGI) both on and off site, trips, transportation to and from trips etc., unless I advise you otherwise in writing. 3. PAYMENT AND CANCELLATION: Registration must be accompanied by a $30.00 non-refundable deposit. However, this fee will be waived if registration is submitted with the first week’s tuition before April 19th , 2024 and is non-refundable. Camp tuition may be paid weekly, one week in advance or in full prior to camp. The first week’s tuition must be paid by June 14th , 2024. 4. MEDICAL CARE: In case of emergency, I hereby give permission to the physician selected by the camp director, to hospitalize, to secure proper treatment for and to order injection, anesthesia, or other procedure deemed necessary for my child by an M.D. as named on this form or if unavailable another M.D. Every effort will be made to contact the parent / Legal Guardian and emergency contacts first. Should it be necessary for the well being of the camper to utilize outside medical or dental services, all expenses involved will be paid for by the Parent. To the best of my knowledge, my child is in good health and I will notify the camp if he/she is exposed to any infectious diseases. I understand that my child may be dismissed during a camp day, due to illness, at the discretion of the camp, and I agree to abide by the Director’s decision. I also agree to submit a copy of both sides of my child/s insurance card with registration and understand that without it my child will not be admitted to camp. 5. IMAGES, ETC: Permission is hereby given to use in promoting the Camp and in other ventures directly relating to the Camp (i) digital, photographic and video images or likenesses of camper; audio of camper; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by camper or originating from Camp or from a Camp-related activity. 6. INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless Camp Gan Israel (CGI) and its officers, servants or assigns from any liability concerning our child’s involvement in CGI and further agree that the use of any premises during the CGI camp day is made at the risk of the registrant. I hereby permit my child to participate in all activities of Camp Gan Israel - on site, off site and trips. I understand that my child may be dismissed during a camp day, due to illness, or misbehavior, at the discretion of the camp, and I agree to abide by the director’s decision. The parent who signs this registration form represents that s/he has full authority to do so and will be responsible for payment of the camp fees. I fully understand and agree to abide by the Terms and Agreements of the camp.