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Winter Camp 2021 Registration form

  • CGI Winter Camp 2021 Registration form

  • For any questions or more info, contact Rabbi Mendel Stiefel.

    972-625-1525 #105 or email [email protected]  

  • Family information

  • Camper Information

  • Please pick the dates you would like to register your child for.

    Either pick the entire week or individual days.

  • Child #2 - Camper Information

  • Health Form Waiver

  • To the best of my knowledge, history is correct and complete; I know of no reason to restrict applicant's activity, and give my permission for participation in all activities, except as specifically noted herein. In the event that I cannot be reached in an EMERGENCY, I hereby give permission to the physician selected by the Camp Director to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child as named above. I also understand that if my child has a medical condition that may require medication, inhaler, EpiPen or the like, that I MUST submit these along with any necessary form signed by my doctor prior to or on the first day of camp. The above includes an Allergy Action Plan for any type of Allergy. Phone orders from parents requesting the camp administration to administer any medication including 'over the counter' will not be accepted.

  • Payment form

  • $0.00
  • Credit Card
    Billing Address
  • Refund policy

    We are unable to offer any refunds for illness of a camper that prevents him/her from attending our program.

  • Waiver

  • Chabad Center of Northwest NJ Waiver of Liability Agreement I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue Chabad Center of Northwest NJ and individually, its officers, employees, and agents from liability from any and all claims, lawsuits and liability, including the negligence of 'Chabad Center NWNJ' its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation of my child in Gan Israel Winter Camp which is a division of the The Chabad Center of NWNJ and is being conducted on ts property. The above shall includes all matters related to the COVID-19 (coronavirus) pandemic. Acknowledgement of Understanding: I have read this waiver of liability, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

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