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Gan Yisrael @ Sinai Indaba

Family Information
Family Name   Fathers Name   Mothers Name
Fathers Cell #    Mothers Cell #   Email 
Marital Status Married Divorced Separated Widowed Other
Camper Information
Child #1
Full Name   Called By   Allergies 
Gender   Age   Hours
Child #2
Full Name   Called By   Allergies 
Gender   Age   Hours 
Emergency Contact
Name   Relationship   Phone

The cost for the day is fully covered by Sinai Indaba


I give my permission to use the photograph of my child as well as myself for promotional purposes.

My child has my permission to participate in Camp Gan Yisrael Day Camp @ Sinai Indaba. 

I understand that in case of emergency and I am unable to be contacted, I give permission to Camp Gan Ysrael to authorize any emergency action necessary to insure the safety of my child.

I understand that by participating in any Camp Gan Yisrael activities and use of any recreational facilities involves risk of accidental injury despite all safety precautions. Having been informed of the activities to be conducted by the Camp Gan Yisrael, I/ We as an individual or as a parent or guardian of the participants named herein, assume all risk and hazards incidental to the activities and release from responsibility and agree to indemnify and hold harmless the Camp Gan Yisrael, its officers, directors, independent contractors, volunteers and all employees for any illness or injury to me or my children or family members occurring during his/her/our participation in any activities or use of any facilities at or conducted by Camp Gan Yisrael.

I understand that by enrolling in Camp Gan Yisrael I am agreeing to abide by all its policies.