Camp Gan Izzy 2026 Registration - Chabad of NW Bergen County

Camp Gan Izzy is BACK for ages 4-11 with a two week teaser led by BATSHEVA Kaplan!! Give your child a Jewish experience of a lifetime in a very nurturing environment.

Camper Information

How many Campers are you registering?*

Camper 1

Full Name*

First Name Last Name

Child's Hebrew Name

Date of Birth*

Month Day Year

Age*

Grade currently in*

Please indicate below if child is: Jewish by birth (JBB) / Conversion* (C) / Non-Jewish (NJ)

*Certificate of conversion required

Child is:*

Jewish by Birth (JBB)Conversion (C)Non-Jewish (NJ)

Does your child have any allergies?* If yes, please specify. If no, please write N/A.

Does your child have any behavioral habits?* If yes, please specify. If no, please write N/A.

Does your child take any medications?* If yes, please specify. If no, please write N/A.

Camper 2

Full Name*

First Name Last Name

Child's Hebrew Name

Date of Birth*

Month Day Year

Age*

Grade currently in*

Please indicate below if child is: Jewish by birth (JBB) / Conversion* (C) / Non-Jewish (NJ)

*Certificate of conversion required

Child is:*

Jewish by Birth (JBB)Conversion (C)Non-Jewish (NJ)

Does your child have any allergies?* If yes, please specify. If no, please write N/A.

Does your child have any behavioral habits?* If yes, please specify. If no, please write N/A.

Does your child take any medications?* If yes, please specify. If no, please write N/A.

Camper 3

Full Name*

First Name Last Name

Child's Hebrew Name

Date of Birth*

Month Day Year

Age*

Grade currently in*

Please indicate below if child is: Jewish by birth (JBB) / Conversion* (C) / Non-Jewish (NJ)

*Certificate of conversion required

Child is:*

Jewish by Birth (JBB)Conversion (C)Non-Jewish (NJ)

Does your child have any allergies?* If yes, please specify. If no, please write N/A.

Does your child have any behavioral habits?* If yes, please specify. If no, please write N/A.

Does your child take any medications?* If yes, please specify. If no, please write N/A.

Parent Information

Father's Name*

First Name Last Name

Mobile*

Area Code Phone Number

E-mail*

Mother's Name*

First Name Last Name

Mobile*

Area Code Phone Number

E-mail*

Please indicate below if child/children's mother is:
Jewish by birth (JBB) / Conversion* (C) / Non-Jewish (NJ)

*Certificate of conversion required

Mother is:*

Jewish by Birth (JBB)Conversion (C)Non-Jewish (NJ)

Home Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number*

Emergency Information

Emergency Contact*

First Name Last Name

Relationship to child*

Mobile*

Area Code Phone Number

Other Person Authorized to Pick-up Child

Name*

First Name Last Name

Relationship to child*

Mobile*

Area Code Phone Number

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Accident, Field Trip and Privacy Declaration

Accident

As the parent(s) or legal guardian of my/our child, I/we authorize any adult acting on behalf of NW Bergen County Hebrew School to hospitalize or secure treatment for my child; I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, NWBC Hebrew personnel will try, but are not required to communicate with me prior to such treatment.

Agreement*

I Agree

Date*

Month Day Year

Trips & Outings

I hereby give permission for my child to attend and participate in all trips and outings organized as part of the program by NW Bergen County Hebrew.

Agreement*

I Agree

Date*

Month Day Year

Privacy

I hereby give permission for my child’s photographs/videos to be used for educational or promotional purposes, which include but are not limited to, brochures, NW Bergen County Hebrew website and NW Bergen County Hebrew social media. I understand that I can withdraw my consent at any time.

Agreement*

I Agree

Date*

Month Day Year

Billing

Child 1 will be attending:* $350 per week. Please select all that apply:

Week 1 & 3 (both half weeks July 7-10, 20-22)Week 2 (July 13-17)

Child 2 will be attending:* $350 per week. Please select all that apply:

Week 1Week 2Week 3

Child 3 will be attending:* $350 per week. Please select all that apply:

Week 1Week 2Week 3

Total

$0.00

Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment*

Credit Card Paypal

Postal / Zip Code

Country

Notes

I would like to receive news and updates by email

Summer Camp Enrollment Form 2026

Payment