Leave this field empty

2018 Camp Gan Shalom Registration Form for InterfaithFamily


Camp Gan Shalom - 114A W. Lime Ave., Monrovia, 91016
Phone 626.445.0810 - Fax 626.445.5977
ganshalom@jewishsgpv.org
*** PLEASE DO NOT USE ONLINE REGISTRATION IF YOU ARE APPLYING FOR A SCHOLARSHIP. DOWNLOAD THE REGISTRATION FORM FROM OUR WEBSITE AND MAIL IT TO OUR OFFICE ***

Camper 1 Information

Male
Female

Please Check the Session(s) that the camper will be attending:

Pasadena Jewish Temple & Center
1434 N. Altadena Dr., Pasadena

June 18 - June 22 $290.00
June 25 - June 29 $290.00
July 2 - July 6 (no camp on 7/4) $270.00
July 9 - July 13 $290.00
June 18 - July 6 $950.00
EXTRA WEEK (July 9- July 13) $315.00

( No multiple week discount applies. Only campers who have signed up for Manheegim's regular session can sign up for the extra week)

Temple Beth Israel of Pomona
3033 N. Towne Avenue, Pomona

July 16 - July 20 $290.00
July 23 - July 27 $290.00
July 30 - August 3 $290.00
July 16- August 3 $1,000.00

( No multiple week discount applies)

Multiple Week Discount (KEHILLA ONLY) : If you child is attending more than 1 week of camp, you will get a discount. Please type in the number of weeks your child is attending in the corresponding box, to get the discount. Please make sure to pick the right box, corresponding to the number of weeks your child is attending. Please note that the multiple week discount is applied per camper. If you have any questions feel free to contact our office 626.445.0810

Type in the number of weeks if 2 - 3 per camper

Type in the number of weeks if 4 - 5 per camper

Type in the number of weeks if 6 - 7 per camper

Enter number of weeks camper will need transportation

After Camp Care
There is either a $12/day or $50 week fee for any camper who stays for After-camp care

Enter the number of days camper will stay for After-camp care.

Enter the number of weeks camper will stay for After-camp care

Camper 2 Information

Male
Female

Please Check the Session(s) that the camper will be attending:

Pasadena Jewish Temple & Center
1434 N. Altadena Dr., Pasadena

June 18 - June 22 $290.00
June 25 - June 29 $290.00
July 2 - July 6 (no camp on 7/4) $270.00
July 9 - July 13 $290.00
June 18 - July 6 $950.00
EXTRA WEEK (July 9- July 13) $315.00

( No multiple week discount applies. Only campers who have signed up for Manheegim's regular session can sign up for the extra week)

Temple Beth Israel of Pomona
3033 N. Towne Avenue, Pomona

July 16 - July 20 $290.00
July 23 - July 27 $290.00
July 30 - August 3 $290.00
July 16- August 3 $1,000.00

( No multiple week discount applies)

Multiple Week Discount (KEHILLA ONLY) : If you child is attending more than 1 week of camp, you will get a discount. Please type in the number of weeks your child is attending in the corresponding box, to get the discount. Please make sure to pick the right box, corresponding to the number of weeks your child is attending. Please note that the multiple week discount is applied per camper. If you have any questions feel free to contact our office 626.445.0810

Type in the number of weeks if 2 - 3 per camper

Type in the number of weeks if 4 - 5 per camper

Type in the number of weeks if 6 - 7 per camper

Enter number of weeks camper will need transportation

After Camp Care
There is either a $12/day or $50 week fee for any camper who stays for After-camp care

Enter the number of days camper will stay for After-camp care.

Enter the number of weeks camper will stay for After-camp care

Parent Information

Both Parents
Parent 1
Parent 2
Other
Friend
Synagogue
Mailing
Other

Consider making a 100% tax-deductible gift to the Jewish Federation

Jewish Federation of the Greater San Gabriel and Pomona Valleys focuses its energies on building a community that takes pride in strengthening and enhancing Jewish life in our community. Our Jewish Federation sponsors and facilitates programs throughout the year that: give people a sense of pride in their Judaism; bring Jews from across the greater San Gabriel and Pomona Valleys together for Jewish events and causes; serve as a voice to the broader community; and much more. Your donation will greatly assist us in making all this possible in and for our community.

$

Camp Gan Shalom Agreement

1. I hereby enroll my child in Camp Gan Shalom, the Jewish Federation of the Greater San Gabriel and Pomona Valleys summer day camp program and agree to pay the established fee for my child’s session(s).

2. The applicant and camper agree to abide by the camp's policies and regulations. Camp Gan Shalom reserves the right to reject any application, dismiss any camper for not conforming thereto, or to cancel any program due to insufficient registration. If the camper withdraws or is sent home during the course of the summer, there shall be no refund of fees.

3. The camp does not assume responsibility for loss or damage to baggage or personal belongings during the period of time a camper is at camp. The applicant and camper agree to reimburse the camp for any unforeseen expenses the camp incurs on the camper's behalf (special supplies or emergency expenses, etc.).

4. All parents/guardians of campers must submit, prior to the start of their camp session, written verification of the camper's good health and suitability to participate in the programs selected.

5. The undersigned consents to the use of the camper's name, photograph, or other identification in connection with the camps' or Federation’s programs, exchanges or publicity.

6. I hereby certify that all information given is true and correct and I agree to all the provisions of the agreement.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Account Details

Enter your name and e-mail address for your confirmation:

Payment Information

Increase the amount by 3% to cover credit card fees. Please select YES to increase your payment.
Total: