Thank you for expressing interest in our summer camp!Below are the Dates and Divisions for Summer Camp 2022 with Aventura Chabad:DATES:June 13-July 29(Full camp experience available for 7 weeks)1 st Session: June 13-July 82nd Session: July 11-July 29 (First session runs for 4 weeks, Second session runs for 3 weeks)1. Child/ren’s InformationChild 1*First NameLast NameBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGender*MaleFemaleDIVISIONS:*TINY TOTS (2 Years)MINI GAN IZZY (3 - 4 Years)GAN IZZY (5 - 9 Years)T-SHIRT FEE:4 T-Shirts per child$40T-SHIRT SIZE:XS (4-5)S (6-7)M (8-10)L (12-16)ENTIRE SUMMER:TINY TOTS: ($1,200)MINI & GAN: ($1,400)SESSION - TINY TOTS:Session 1 ($800)Session 2 ($600)SESSION - MINI & GAN:Session 1 ($1,000)Session 2 ($750)WEEKLY - TINY TOTS: ($250 per child)Week 1Week 2Week 3Week 4Week 5Week 6Week 7WEEKLY - MINI & GAN: ($300 per child)Week 1Week 2Week 3Week 4Week 5Week 6Week 7*I have emailed medical forms to: [email protected]All vaccines are up to dateSignature:*Child 2First NameLast NameBirth Date1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGenderMaleFemaleDIVISIONS:TINY TOTS (2 Years)MINI GAN IZZY (3 - 4 Years)GAN IZZY (5 - 9 Years)T-SHIRT FEE:4 T-Shirts per child$40T-SHIRT SIZE:XS (4-5)S (6-7)M (8-10)L (12-16)ENTIRE SUMMER:TINY TOTS: ($1,200 per child)MINI & GAN: ($1,400 per child)SESSION - TINY TOTS:Session 1 ($800)Session 2 ($600)SESSION - MINI & GAN:Session 1 ($1,000)Session 2 ($750)WEEKLY - TINY TOTS: ($250 per child)Week 1Week 2Week 3Week 4Week 5Week 6Week 7WEEKLY - MINI & GAN: ($300 per child)Week 1Week 2Week 3Week 4Week 5Week 6Week 7I have emailed medical forms to: [email protected]All vaccines are up to dateSignature:If you have additional children please contact us.2. Parent informationAddress:*Street AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryMother's infoFirst NameLast NameWork PhoneArea CodePhone NumberE-mailPrimary emailCell Phone*Area CodePhone NumberFather's infoFirst NameLast NameWork PhoneArea CodePhone NumberE-mailCell Phone*Area CodePhone Number3. Emergency InformationEmergency Contact*First NameLast NamePhone Number*Area CodePhone NumberRelationship*Pediatrician & InsuranceFirst NameLast NamePhone NumberArea CodePhone NumberInsurancePolicy #4. Payment InformationNon-refundable registration fee$100A $100 non-refundable registration fee applies as part of this registration.Total Amount:$0.00Payment:*Credit CardVisaMasterCardAmerican ExpressDiscoverCredit Card TypeCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2022202320242025202620272028202920302031Expiration YearPayment Options:Full Payment2 Payments3 Payments4 PaymentsPlease indicate any specific information that you think is necessary here:Agreement*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.Should be Empty: Submit This page uses TLS encryption to keep your data secure.