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	Summer Camp Gan Izzy 2011

Summer Camp 30th July - 17th August 2012 Book Early - Limited spaces

Camp Gan Israel Ilford - 41th Year

Application Form - Summer Camp

2012 - 5772
Ilford Day Camp

Full day camp for 2 year olds!

Before and After Camp Care

The form below is for Kiddie Camp (Nursery & Reception) and
the Main Primary School age camp.

If you child is already attending High School (Years 7 – 9)

Please follow this link to the Teen Camps Application form

Juniors and Kiddie Camp
1st Week - Monday 30th July - Friday 3rd July 2012
2nd Week - Monday 6th - Friday 10th August 2012

Juniors Only (Over 8's)
3rd Week - Monday 13th - Friday 17th August 2012

Venue: 1st Week - King Solomon High School - Forest Road, Barkingside
2nd Week - King Solomon High School - Forest Road, Barkingside
3rd Week - Chabad Lubavitch Centre - 395 Eastern Avenue, Gants Hill

Time:    Monday - Wednesday 9.30am to 3.30pm
            (Monday-Wednesday: Before and After care 8:00am-9:30am and 3:30pm-5:00pm)
            Thursday - 9.30am to 6.00pm - pick up from Chabad - 395 Eastern Avenue
            Friday 9.30am to 12.30pm
            (Thursday-Friday: Before care 8:00am-9:30am)

Kiddie camp (Nursery and Reception) finish on a Thursday as normal at 3.30pm
After Camp Care Available till 5:00pm

Cost: Includes lunch each day.

Juniors    (2-11 years old)
              1 Week - £80.00   2 Weeks - £150.00    3 Weeks - £195.00
               Before and After Camp Care = £2.00 per session (£4.00 for both per day)

               Early bird prices - Book and pay by 1st June 2011
               1 Week - £70.00   2 Weeks - £135.00    3 Weeks - £180.00
               Before and After Camp Care = £2.00 per session (£4.00 for both per day)

Should you feel that your 2 year old is not ready for a whole day of fun,
we would be open to discuss single sessions (either mornng or afternoon)

(Please note that week 3 is for over 8's only)
Which week(s) are you applying for?

	Before Care	After Care
Week 1	Monday Tuesday Wednesday Thursday	Monday Tuesday Wednesday Thursday
	Friday
Week 2	Monday Tuesday Wednesday Thursday	Monday Tuesday Wednesday Thursday
	Friday
Week 3	Monday Tuesday Wednesday Thursday	Monday Tuesday Wednesday Thursday
	Friday

Part 1 - Family Details

(Please fill in a seperate form for each child)

Family Name
Childs First Name(s)
E-mail Address
Childs Hebrew Name
	Male Female
Date of Birth
Age
Address
Post Code
Name of Day School
Hebrew Classes
Parents Names
Mother's Hebrew Name
Father's Hebrew Name
Synagogue Where Married
Current Synagogue Membership
Telephone: Home
Telephone Mobile
Telephone Business
Other
First Language
Other Languages Spoken at Home

Part 2 - Medical History

Family Doctor
Telephone Number
Address
Has your child been immunised against?
Diptheria	Yes No
Whooping Cough	Yes No
Tetanus	Yes No
Polio	Yes No
Measles	Yes No
HIB	Yes No
Does your child suffer from any allergies?	Yes No
	Please give details
Does your child suffer from any ongoing health problems?	Yes No
	Please give details
Has your child been in hospital lately?	Yes No
	Please give details
Does your child have any special dietary needs?	Yes No
	Please give details
Does your child have any special educational needs?	Yes No
	Please give details

Part 3 - Emergency Contacts

1st Person - Name
Relationship to child
Telephone Home
Telephone Mobile

2nd Person - Name
Relationship to child
Telephone Home
Telephone Mobile

3rd Person - Name
Relationship to child
Telephone Home
Telephone Mobile

We take photos of campers for the media, our website and Facebook. If you feel strongly against this please write to tell us.

I understand that in the event of an emergency the staff at Camp Gan Israel Ilford will contact me immediately. In the event that I, or my named emergency contact(s) cannot be reached, I understand that emergency treatment and / or advice will be saught for my child and I will be informed as soon as possible.

Please fill in your name and click the yes radial button to accept these terms:
I have read and accept the terms
above No Yes

A member of staff at Chabad will contact you for details of how you would like to pay. Many thanks in advance.

Camp Gan Israel - N. E. London and Essex • 395 Eastern Avenue • Ilford, IG2 6LR • England • 44-20-8554-1624 - Charity Reg: 1123001
A branch of the world's largest Jewish Camping network, Camp Gan Israel International