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Winter Camp 2019 Registration

First & Last

Mother/Guardian Information

Father/Guardian Information


*Family Information 
*We ask these questions in order to better understand and relate to each child.

Camper Information

Camper 1 will attend:
Please select EITHER the entire winter camp week OR individual days.  To avoid overpayment, please do not make selections that overlap.

Camper 2 will attend:
Please select EITHER the entire winter camp week OR individual days.  To avoid overpayment, please do not make selections that overlap.

Camper 3 will attend:
Please select EITHER the entire winter camp week OR individual days.  To avoid overpayment, please do not make selections that overlap. 

Permission, Release & Waiver of Liability:  
By completing this enrollment form and entering my digital signature below, I as the parent or legal guardian of the above child(ren) hereby release Chabad of Lakeview from any and all liability arising from claims for injuries or damages that either individually or on behalf of my child might occur during participation in Camp Gan Israel activites.  I authorize any adult acting on behalf of Chabad of Lakeview's Camp Gan Israel program to treat, hospitalize, or secure treatment for my child.  I further agree to pay all charges for that care and/or treatment.  It is understood that if time and circumstances reasonably permit, Camp Gan Israel personnel will try, but are not required, to communicate with me prior to such treatment.  I hereby give permission for my child to participate in all camp activities and field trips.  I understand that my child may be photographed while participating in Camp Gan Israel activities and that these pictures may be used for marketing purposes.  By electronically signing my name below, I accept these terms and conditions.
Enter first & last name

 

Sun, December 15 2019 17 Kislev 5780