Camp Registration - ChabadFL.org

REGISTRATION NOW OPEN!

DATES:

June 16-August 1

(Full camp experience available for 7 weeks)
Number of children being registered:*
1. Child/ren’s Information
Child 1*
First Name Last Name
Hebrew Name
Birth Date*

Month Day Year
Time of Birth
Gender*

MaleFemale
DIVISION:*

TINY TOTS (2 Years)MINI GAN IZZY (3 - 4 Years)GAN IZZY (5 - 9 Years)
T-SHIRT FEE: 4 T-Shirts per child

$40
T-SHIRT SIZE

XS (4-5)S (6-7)M (8-10)L (12-16)
T-SHIRT SIZE:

XS (4-5)S (6-7)M (8-10)L (12-16)
CHILD 1 ATTENDING:*

TINY TOTS (AGE 2) ENTIRE SUMMER: (Early Bird: $2,100 / $2,200 after March 15)MINI (AGES 3-4) & GAN IZZY (AGES 5-9) ENTIRE SUMMER: (Early Bird: $2,400 / $2,500 after March 15)WEEKLY - TINY TOTS (AGE 2): (Early Bird: $325 weekly / $350 weekly after March 15)WEEKLY - MINI (AGES 3-4) & GAN IZZY (AGES 5-9): (Early Bird: $375 weekly / $400 weekly after March 15)
CHILD 1: EARLY BIRD WEEKLY - TINY TOTS: ($325 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
CHILD 1: EARLY BIRD WEEKLY - MINI & GAN: ($375 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
If you'd like to make a friend request for your child to be placed in the same bunk, please provide their full name. Please note it may not be possible your child is placed with all friends requested, but we guarantee he/she will be placed with at least one child requested.
*

I have emailed medical forms to: [email protected]All vaccines are up to date
Please choose one of the following:

My child is toilet trained (Mini & Gan Izzy)NA – My child is in Tiny Tots
Allergies/Special Health Considerations
Signature:*
Child 2
First Name Last Name
Birth Date

Month Day Year
Time of Birth
Gender

MaleFemale
DIVISION:*

TINY TOTS (2 Years)MINI GAN IZZY (3 - 4 Years)GAN IZZY (5 - 9 Years)
T-SHIRT FEE: 4 T-Shirts per child

$40
T-SHIRT SIZE:

XS (4-5)S (6-7)M (8-10)L (12-16)
CHILD 2: ATTENDING:*

TINY TOTS (AGE 2) ENTIRE SUMMER: (Early Bird: $2,100 / $2,200 after March 15)MINI (AGES 3-4) & GAN IZZY (AGES 5-9) ENTIRE SUMMER: (Early Bird: $2,400 / $2,500 after March 15)WEEKLY - TINY TOTS (AGE 2): (Early Bird: $325 weekly / $350 weekly after March 15)WEEKLY - MINI (AGES 3-4) & GAN IZZY (AGES 5-9): (Early Bird: $375 weekly / $400 weekly after March 15)
CHILD 2: EARLY BIRD WEEKLY - TINY TOTS: ($325 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
CHILD 2: EARLY BIRD WEEKLY - MINI & GAN: ($375 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
If you'd like to make a friend request for your child to be placed in the same bunk, please provide their full name. Please note it may not be possible your child is placed with all friends requested, but we guarantee he/she will be placed with at least one child requested.
I have emailed medical forms to: [email protected]All vaccines are up to date
Please choose one of the following:

My child is toilet trained (Mini & Gan Izzy)NA – My child is in Tiny Tots
Allergies/Special Health Considerations
Signature:
Child 3
First Name Last Name
Hebrew Name
Birth Date

Month Day Year
Time of Birth
Gender

MaleFemale
DIVISION:*

TINY TOTS (2 Years)MINI GAN IZZY (3 - 4 Years)GAN IZZY (5 - 9 Years)
T-SHIRT FEE: 4 T-Shirts per child

$40
T-SHIRT SIZE:

XS (4-5)S (6-7)M (8-10)L (12-16)
CHILD 3: ATTENDING:*

TINY TOTS (AGE 2) ENTIRE SUMMER: (Early Bird: $2,100 / $2,200 after March 15)MINI (AGES 3-4) & GAN IZZY (AGES 5-9) ENTIRE SUMMER: (Early Bird: $2,400 / $2,500 after March 15)WEEKLY - TINY TOTS (AGE 2): (Early Bird: $325 weekly / $350 weekly after March 15)WEEKLY - MINI (AGES 3-4) & GAN IZZY (AGES 5-9): (Early Bird: $375 weekly / $400 weekly after March 15)
CHILD 3: EARLY BIRD WEEKLY - TINY TOTS: ($325 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
CHILD 3: EARLY BIRD WEEKLY - MINI & GAN: ($375 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
If you'd like to make a friend request for your child to be placed in the same bunk, please provide their full name. Please note it may not be possible your child is placed with all friends requested, but we guarantee he/she will be placed with at least one child requested.
I have emailed medical forms to: [email protected]All vaccines are up to date
Please choose one of the following:

My child is toilet trained (Mini & Gan Izzy)NA – My child is in Tiny Tots
Allergies/Special Health Considerations
Signature:
Child 4
First Name Last Name
Hebrew Name:
Birth Date

Month Day Year
Time of Birth
Gender

MaleFemale
DIVISION:*

TINY TOTS (2 Years)MINI GAN IZZY (3 - 4 Years)GAN IZZY (5 - 9 Years)
T-SHIRT FEE: 4 T-Shirts per child

$40
T-SHIRT SIZE:

XS (4-5)S (6-7)M (8-10)L (12-16)
CHILD 4: ATTENDING:*

TINY TOTS (AGE 2) ENTIRE SUMMER: (Early Bird: $2,100 / $2,200 after March 15)MINI (AGES 3-4) & GAN IZZY (AGES 5-9) ENTIRE SUMMER: (Early Bird: $2,400 / $2,500 after March 15)WEEKLY - TINY TOTS (AGE 2): (Early Bird: $325 weekly / $350 weekly after March 15)WEEKLY - MINI (AGES 3-4) & GAN IZZY (AGES 5-9): (Early Bird: $375 weekly / $400 weekly after March 15)
CHILD 4: EARLY BIRD WEEKLY - TINY TOTS: ($325 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
CHILD 4: EARLY BIRD WEEKLY - MINI & GAN: ($375 per child)

Week 1: June 16 - June 20Week 2: June 23 - June 27Week 3: June 30 - July 3Week 4: July 7 - July 11Week 5: July 14 - July 18Week 6: July 21 - July 25Week 7: July 28 - August 1
If you'd like to make a friend request for your child to be placed in the same bunk, please provide their full name. Please note it may not be possible your child is placed with all friends requested, but we guarantee he/she will be placed with at least one child requested.
I have emailed medical forms to: [email protected]All vaccines are up to date
Please choose one of the following:

My child is toilet trained (Mini & Gan Izzy)NA – My child is in Tiny Tots
Allergies/Special Health Considerations
Signature:
If you have additional children please contact us.
2. Parent information

Address:*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Mother's info
First Name Last Name
Work Phone

Area Code Phone Number
E-mail Primary email
Cell Phone*

Area Code Phone Number
Father's info
First Name Last Name
Work Phone

Area Code Phone Number
E-mail
Cell Phone*

Area Code Phone Number
Parent’s Marital Status

MarriedDivorcedSeparatedWidowed
If there are Custody Arrangements, please specify here:
3. Emergency Information
Primary Emergency Contact*
First Name Last Name
Phone Number*

Area Code Phone Number
Relationship to Child*
Secondary Emergency Contact
First Name Last Name
Phone Number

Area Code Phone Number
Relationship to Child
Medical Information
Hospital/Clinic Preference*
Physician's Name*
First Name Last Name
Phone Number*

Area Code Phone Number
Insurance
Policy #
Authorization:*

I am signing up my child for camp. I give my child permission to attend all trips and receive medical care in the case of emergency, G-d forbid. I give Gan Israel permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the camp sees fit.I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency.I give permission for my child to go on field trips. I release Aventura Chabad and individuals from liability in case of accident during activities related to Aventura Chabad, as long as normal safety procedures have been taken.By entering your first and last name below, you electronically acknowledge having read and understood this Agreement and agree to the terms and conditions herein.Your first and last name below represents your agreement to all the terms and conditions written above and will serve as your consent to all the terms and conditions written above.
Signature:*
First Name Last Name
Date:*
4. Payment Information
Non-refundable registration fee

$125
Total Amount:

$0.00

Payment:*

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Terms of Agreement
(PLEASE READ CAREFULLY-NO EXCEPTIONS)
A $125 non-refundable registration fee applies as part of this registration.

Discount: When registering siblings, receive 10% off the second child and any subsequent children.

Refund policy: Full refund if canceled by March 15th, 50% refund if canceled by April 15th, no refunds will be given if canceled after April 15th.

All eligible discounts including sibling discounts and early bird promotions will be reduced from your total amount due.

3.5% processing fee added to credit card payments.
I understand:*

1. Payment in full is due with application, including all head checks or credit cards.2. Complete payment is refundable if cancelled before March 15th, 2025 except for $125 non-refundable registration fee, 50% minus $125 non-refundable registration fee is refundable if cancelled before April 15th, 2025. After April 15th, 2025 payment is Non-Refundable, for any reason, even if your child does not attend the program. Once registered, any cancellation will have a non-refundable fee of $125.3. Withdrawal of enrollment privileges, for any reason, does not relieve the Undersigned of the responsibility for the payment of the entire financial obligations for the program you enrolled your child in.4. By entering your first and last name below, you electronically acknowledge having read and understood this Agreement and agree to the terms and conditions herein.5. Your first and last name below represents your agreement to all the terms and conditions written above and will serve as your consent to all of the terms and conditions written above.
Please note, payments are processed manually and we'll deduct the registration fee, and any applicable discounts, if within the deadline.
Signature:*
First Name Last Name
Date:*
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1. Child/ren’s Information

2. Parent information

3. Emergency Information

Medical Information

4. Payment Information

Terms of Agreement