Camper Information
Camper Full Name
Age
Grade For The Fall of 2024
Please select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Birth Date
Hebrew Name
E-mail
T-shirt size options
Please select
Youth XS
Youth S
Youth M
Youth L
Adult S
Please list any medications your child is currently taking. Also, please list any know allergies or medical conditions.
Request a scholarship
We will reach out to discuss scholarships and payment plans.
I will pay later.
I acknowledge that to receive the discount I need to pay by 2/4/2024.
Contact Information
Address
City
State
Zip
Mother's Name
Mother Cell Number
Mother Work Number
Father's Name
Father Cell Number
Father Work Number
Parents are married
Please select
Yes
No
Emergency Contact Information
Emergency Contact
Emergency Contact Relationship
Who should we call first if we need to reach you?
Gan Izzy Registration
We love what GANIZZY does for the kids and community and would Like to help sponsor scholarships.
Amount
Payment Method
Credit Card Information
Type
Visa
MC
Amex
Discover
Number
Expiration
Code
Use contact info above
Name
Address
Zip
Submit
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