Camp Test

CGI Essex

Registration Form
Bookings are open for all camp divisions for the 2nd week, 11-15 August.
The 1st week is only open for Teen Boys, all other divisions for week 1 are sold out.

You can book upto three children using this form
Full Name*
First Name Last Name
Relationship to child*

MotherFatherOther
Synagogue Affilliation
E-mail*
Phone Number*

Address*

Address if different from above*

Childs details
Full Name of child*
First Name Last Name
Childs Hbrew Name
Gender*
Date of birth*

Month Day Year
School Name*
School Academic Year*
Kiddie camp week 1
Weekly or day by day*
Kiddie camp week 1 days*

MondayTuesdayWednesdayThursdayFriday
Junior camp week 1
Weekly or day by day*
Junior camp week 1 days*

MondayTuesdayWednesdayThursdayFriday
Water activities. can your child swim unaided *

YesNo. I will provide necessary equipment
Allergies?*
Extra support in school?*
Aditional info?*
Been to camp before?*

YesNo
Additional child

Yes
Full Name*
First Name Last Name
Gender*
Date of Birth*

Month Day Year
School Name*
School Academic Year*
Kiddie camp 2.0
Weekly or day by day 2.0*
Kiddie camp week 1 days 2.0*

MondayTuesdayWednesdayThursdayFriday
Total

£0.00 GBP

Payment

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Credit Card

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Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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Programs

CGI Essex