<!DOCTYPE HTML PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">

<html xmlns="http://www.w3.org/1999/xhtml" >
<head id="Head1">
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="Content-Language" content="en" />

<meta property="og:image" content="https://w2.chabad.org/media/images/1271/rsfb12718142.png" itemprop="image" width="150" height="150" />
<meta property="og:image:width" content="150" />
<meta property="og:image:height" content="150" />
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=0" />
<meta name="keywords" content="Camp,Registration," />
<meta name="title" content="Camp Registration - Camp Gan Israel" />
<meta property="og:type" content="website" />
<meta name="scope-aids" content="6364241-6364249-6439348-6430169" />
<meta name="article-keywords" content="2185-16403-20429-2170-2898" />
<meta name="scope-aid" content="6364241" />
<meta name="scope-aid" content="6364249" />
<meta name="scope-aid" content="6439348" />
<meta name="scope-aid" content="6430169" />
<meta name="article-keyword" content="2185" />
<meta name="article-keyword" content="16403" />
<meta name="article-keyword" content="20429" />
<meta name="article-keyword" content="2170" />
<meta name="article-keyword" content="2898" />
<meta property="og:url" content="https://www.cgialbanyny.com/templates/articlecco_cdo/aid/6430169/jewish/Register-for-Summer-2026.htm" />
<meta property="twitter:card" content="summary_large_image" />
<meta property="twitter:site" content="@chabad" />
<meta property="og:title" content="Camp Registration" /><link rel="canonical" href="https://www.cgialbanyny.com/templates/articlecco_cdo/aid/6430169/jewish/Register-for-Summer-2026.htm" />
<link rel="icon" type="image/png" href="https://www.cgialbanyny.com/media/images/1271/rsfb12718142.png" />
<link rel="Stylesheet" href="/css/fonts/font-awesome/font-awesome-5.css?v=2D6ABDDB" id="kfont-awesome" type="text/css"/>
<link rel="Stylesheet" href="/css/DefaultGrid.css?v=A13D74E8" id="kgrid" type="text/css"/>
<link rel="Stylesheet" href="/css/Elements.css?v=7A8278DB" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/vendor/ds/tokens/sites.css?v=77EFEE59" id="ksites-ds-css" type="text/css"/>
<link rel="Stylesheet" href="/css/vendor/ds/tokens/sites-light.css?v=F05E3D94" id="ksites-light-ds-css" type="text/css"/>
<link rel="Stylesheet" href="/css/new/main.css?v=220E279D" id="k7" type="text/css"/>
<link rel="Stylesheet" href="/css/global.css?v=27BD2E9E" id="k3" type="text/css"/>
<link rel="Stylesheet" href="/css/global-print.css?v=40836E98" id="k5" type="text/css" media="print"/>
<link rel="Stylesheet" href="/css/Cco/Templates/camp/main.css?v=D8BBD335" id="k8" type="text/css"/>
<link rel="Stylesheet" href="/css/old/global.css?v=43DDBA77" id="k2898" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/forms/formCss2.css?v=AB6A2925" id="kFormCss" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/forms/themes/nova.css?v=87AD6957" id="kNova" type="text/css"/>
<link rel="Stylesheet" href="/css/bootstrap/grid.css?v=F4390F2B" id="kbootstrap4-grid" type="text/css"/>
<link rel="Stylesheet" href="/css/Library/reader-comments.css?v=8AB57D79" id="kCommentsStylesheet" type="text/css"/>
<link rel="Stylesheet" href="/css/inline/BookInfo.css?v=3D052243" id="kBookInfoCss" type="text/css"/>
<!--[if lte IE 8]> <link rel="Stylesheet" href="/css/global-ie.css?v=807ACD6C" id="k4" type="text/css"/> <![endif]-->
<script>$q=[];$j=function(f){$q.push(f);}</script><meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
	
<title>
	Camp Registration - Camp Gan Israel
</title>
	



<script>
	window.dataLayer = window.dataLayer || [];
	dataLayer.push({"event":"datalayer-initialized","page":{"numberOfComments":0,"publicationDate":"2024-05-08","primaryArticleId":6430169,"title":"Camp Registration","author":"","authorId":0,"contentLevel1":"My Site","contentLevel2":"Registration","contentLevel3":"Register for Summer 2026","siteName":"Camp Gan Israel"},"time":{"upcomingHoliday":"Chanukah","daysToUpcomingHoliday":40,"hebrewDate":"5787-08-15"}});
		dataLayer.push({ 'articleHierarchy': '-6364241-6364249-6439348-6430169-', 'keywords': '-k2898-k2170-k20429-k16403-k2185-', 'k': '-6364241-6364249-6439348-6430169--k2898-k2170-k20429-k16403-k2185-' });
	
</script>
<script>

(function(c,h,a,b,a,d){c[a]=c[a]||[];c[a].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=h.getElementsByTagName(b)[0],
j=h.createElement(b);j.async=true;
j.src='https://w6.chabad.org/mitzvah-tank.js';f.parentNode.insertBefore(j,f);
})(window,document,0,'script','dataLayer');</script>

	<!-- Start of StatCounter Code -->
	<script type="text/javascript">
	var sc_project = 12978170;var sc_partition = 80;var sc_invisible = 1;var sc_remove_link=1;var sc_security = "17815210";var sc_https = 1;
	</script>
	<script type="text/javascript" src="https://secure.statcounter.com/counter/counter_xhtml.js" defer async></script>
	<noscript><img src="//c81.statcounter.com/counter.php?sc_project=12978170&amp;java=0&amp;security=17815210&amp;invisible=1" border="0" /> </noscript>
	<!-- End of StatCounter Code -->


<style>

/* button */

.userform-form .form-buttons-wrapper .form-submit-button {
background-color: #4abdc7;
      border-bottom: none;
      border-radius: 50px;
text-transform: none;
letter-spacing: .8px;
}


/* homepage content */

.hp-row-first .cycle-directionNav a {
display: none;
}

.hp-row-first .cycle-caption .readMore, .registration__action__register {
    border-bottom: none;
    
    border-radius: 50px;
    font-family: 'Lato';
    text-transform: none;
    font-weight: 600;
    letter-spacing: .5px;
}

.hp-row-first .cycle-caption p {
    background: transparent;
}

.hp-row-first .cycle-caption big {
text-transform: none;
    line-height: 100%;
    margin-bottom: 19px;
}

.header__extended .header__contact, .header__extended .header__mail, .header__extended .header__phone {
        margin: 6px 0;
}
.master-content-wrapper .article-header {
text-align: center;
}
.hp-row-first .cycle-caption span {
margin-bottom: 40px;
}
.header__extended {
 
    height: 30px;
}
/* colors*/

.header__extended .header__contact a, .header__extended .header__mail a, .header__extended .header__phone a {
    color: #fff !important;
    letter-spacing: .5px;
    font-weight: 500;
    text-transform: none;
font-size: 15px; 
font-family: "open sans";
}

.header-logo__subtitle {
           color: #202020;
    font-weight: 600;
font-family: "open sans";
    letter-spacing: .9px
}
.footer {
    background-color: #0078c2;
}

.footer__extended {
    border-bottom: 1px solid #045a8f;
}
.footer__information>div {
    background-color: transparent;
}
.footer__address__container {
border-bottom: none;
}

.nav-menu.--collapsed .nav-menu__item.current-menu-item>a, .nav-menu.--collapsed .nav-menu__item.current-menu-parent>a, .nav-menu.--collapsed .nav-menu__item:hover>a {
    color: #C7B74A;
}

.header-logo__title, .no-hero-image .master-content-wrapper h1, .latest_blogs .widget_header {
    color: #4abdc7;
}

.nav-menu.--collapsed .nav-menu__item>a, .nav-menu.--collapsed .nav-menu__item .fal:before, .header__extended .header__contact a, .header__extended .header__mail a, .header__extended .header__phone a {
color: #202020;
}


.nav-menu.--collapsed .nav-menu__submenu {
background-color: #C7B74A;
}


.nav-menu.--collapsed .nav-menu__item .fal:before:hover {
    color: #C7B74A;
}

.nav-menu.--collapsed .nav-menu__submenu-item a:hover {
background-color:  #4abdc7;
}

.co_body h2 {
    color: #0078c2;
       font-weight: 600;
    font-family: 'Lato';
    text-transform: uppercase;
}


.header__extended {
    background-color: #C7B74A;
}

/* registration form */




.form-header-group .form-subHeader {
color: #fff;
}


H3.form-header {
      color: #0078c2;
    font-family: 'Lato';
    text-transform: uppercase;
    font-size: 20px;
    letter-spacing: .7px;
}


H2.form-header {
color: #fff;
    display: inline;
font-size: 22px;
    text-transform: none;
margin: 0;
padding: 7px 12px;
    border-radius: 8px;
    background: #0078c2;
}

.form-header-group {
margin-left: 0;
margin-bottom: -13px;
}


.userform-form label span {
color: #000;
}

li#id_129 {
    border-bottom: 0;
    margin-bottom: -20px;
}
/* hide label for terms checkboxes */


div#label_160, div#label_161, div#label_162, div#label_163, div#label_164 , div#label_165, div#label_166 {
 display: none !important;
}


/* --- 2 fields per row */

div#label_149, div#label_150, div#label_152, div#label_154, div#label_155, div#label_151, div#label_153, div#label_156 {
    display: block;
}

/* -------right side field */
li#id_150, li#id_152, li#id_154, li#id_155 {
    width: 40%;
    display: inline-block;
}

/*--------left side field */
li#id_149, li#id_151, li#id_153, li#id_156 {
    width: 40%;
    float: left;
margin-left: 10px;
    display: inline-block;
margin-left: 0;
}



/* about */

.about--blocks ul {
    display: none;
}
.about--blocks .container {
       background: #4abdc7;
border-radius: 20px;
}

.about--blocks .container h2 {
      font-family: "Poppins";
    font-weight: 600;
    line-height: 114%;
    margin-bottom: 16px;
}

.about--blocks .container>p {
       font-family: "poppins";
    font-weight: 400;
    font-size: 17px;
       letter-spacing: .4px;
}


/* nav */

.header__main .nav-menu .nav-menu__item:last-child {
    background: #009eff;
    height: 41px;
    padding: 5px 25px;
       border-radius: 50px;
}

.header__main .nav-menu .nav-menu__item:last-child:hover {
background: #0686d5;
}

.header__main .nav-menu .nav-menu__item:last-child > a {
    color: #fff;
padding-right: 0;
}

.header__main .nav-menu .nav-menu__item:last-child:after {
    content: "\232A\232A";
    font-size: 11px;
    position: relative;
    padding-left: 6px;
      font-weight: bold;
color: #fff !important;
}

.header__main .nav-menu .nav-menu__item:last-child i {
display: none;
}

.nav-menu.--collapsed .nav-menu__item>a {
font-size: 17px;
}

.chabad_updates .wrapper {
    background-color: #C7B74A;
border-radius: 30px;
height: 500px;
}


.latest_photos .wrapper {
    max-width: 100%;
    padding: 0;
}
.latest_photos .wrapper li {
    padding: 6px;
}

.latest_photos .widget_header {
display: none;
}
.latest_photos {
padding-bottom: 0;
background-color: #fff;
border-top: 0;
margin-top: 60px;
}


.body_wrapper:not(.no-hero-image) .master-content-wrapper.g960 {
    background-blend-mode: multiply;
    background-color: #2020206e;
}

/* mobile */
@media screen and (max-width: 700px) {

.master-content-wrapper {
    padding-top: 41px;
    padding-bottom: 46px;
}
.master-content-wrapper h1 {
    font-size: 30px;
        letter-spacing: 1px;
   }

.hp-row-first .cycle-caption .readMore {
    padding: 10px 29px 14px 29px;
}

    .header__main .nav-menu .nav-menu__item:last-child {
        height: auto;
        display: flex;
        margin-left: 25px;
        margin-right: 25px;
        border-radius: 50px;
        margin-top: 30px;
    }


}



.header__toggle .burger-icon, .header__toggle .burger-icon::after, .header__toggle .burger-icon::before {
background-color: #0078c2 !important;
}

.header__toggle .burger-icon, .header__toggle .burger-icon::after, .header__toggle .burger-icon::before {
    background-color: #009eff;
}
</style>

<link rel="stylesheet" href="https://assets.webmk.co/cgi-albany/style.css" />
</head>
<body class="lang_en dir_ltr cco_body form secure">
	
	<div class="header">
		<div class="header__extended">
			<div class="wrapper">
				
				    <div class="header__phone">
					    <a href="tel:518-698-1836"><i class="fas fa-phone icon"></i>518-698-1836</a>
				    </div>
                
				
					<div class="header__mail">
						<a href="mailto:&#100;&#101;&#118;&#111;&#114;&#97;&#108;&#101;&#64;&#103;&#109;&#97;&#105;&#108;&#46;&#99;&#111;&#109;"><i class="fas fa-envelope icon"></i>&#100;&#101;&#118;&#111;&#114;&#97;&#108;&#101;&#64;&#103;&#109;&#97;&#105;&#108;&#46;&#99;&#111;&#109;</a>
					</div>
				
				
				    <div class="header__contact">
					    <a href="/tools/feedback.asp">Contact Us</a>
				    </div>
				
			</div>
		</div>
		<div class="header__main">
			<div class="wrapper">
				<div class="header__toggle">
					<a href="#"></a>
					<span class="burger-icon"></span>
				</div>
				<div class="header-logo">
					<a href="/" class="header-logo__link">
						<img src="https://w2.chabad.org/media/images/1271/rsfb12718142.png" width="100" height="100" border="0"  />
						<div class="header-logo__text">
							<h1 class="header-logo__title" title="Camp Gan Israel">Camp Gan Israel</h1>
							<h2 class="header-logo__subtitle" title="of Greater Albany">of Greater Albany</h2>
						</div>
					</a>
				</div>
				
            <ul class="nav-menu js-header-menu --collapsed js-expandable">
    
        <li class="nav-menu__item nav-menu__item--has-children js-menu-item-has-child">
            <a href="/templates/articlecco_cdo/aid/6380655/jewish/About.htm">About</a>
			
				<i class="fal fa-angle-down fa-2x"></i>
			
        
                <ul class="nav-menu__submenu js-submenu">
            
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439332/jewish/About-Our-Camp.htm">About Our Camp</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439334/jewish/Our-Mission.htm">Our Mission</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292424/jewish/Why-We-CGI.htm">Why We ❤ CGI</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292429/jewish/Message-from-the-Director.htm">Message from the Director</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292431/jewish/Our-Facility.htm">Our Facility</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439336/jewish/Frequently-Asked-Questions.htm">Frequently Asked Questions</a>
                        </li>
                    
                </ul>
            
    
        <li class="nav-menu__item nav-menu__item--has-children js-menu-item-has-child">
            <a href="/templates/articlecco_cdo/aid/6439339/jewish/Program.htm">Program</a>
			
				<i class="fal fa-angle-down fa-2x"></i>
			
        
                <ul class="nav-menu__submenu js-submenu">
            
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439340/jewish/Calendar-2026.htm">Calendar 2026</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292670/jewish/Activities.htm">Activities</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439341/jewish/Trips-Swimming-Transportation.htm">Trips, Swimming, & Transportation</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439343/jewish/Lunch.htm">Lunch</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439344/jewish/Jewish-Theme.htm">Jewish Theme</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292674/jewish/Parent-Handbook.htm">Parent Handbook</a>
                        </li>
                    
                </ul>
            
    
        <li class="nav-menu__item ">
            <a href="/templates/photogallery_cdo/aid/6443504/jewish/Photos.htm">Photos</a>
			
        
    
        <li class="nav-menu__item nav-menu__item--has-children js-menu-item-has-child">
            <a href="/templates/articlecco_cdo/aid/6439348/jewish/Registration.htm">Registration</a>
			
				<i class="fal fa-angle-down fa-2x"></i>
			
        
                <ul class="nav-menu__submenu js-submenu">
            
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6430169/jewish/Register-for-Summer-2026.htm">Register for Summer 2026</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439349/jewish/Dates-Rates.htm">Dates & Rates</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439351/jewish/Financial-Questions.htm">Financial Questions</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6978483/jewish/Payment.htm">Payment</a>
                        </li>
                    
                </ul>
            
    
        <li class="nav-menu__item ">
            <a href="/templates/articlecco_cdo/aid/6546606/jewish/Donate.htm">Donate</a>
			
        
    
            </ul>
    

			</div>
		</div>
	</div>
	<div id="BodyContainer">
		<div class="body_wrapper no-hero-image clearfix">
			
	<div class="co_content_container clearfix local_content" id="co_content_container">
		<div class="clearfix">
			
			
			
			<div class="clearfix bh mobile-only align_right">ב"ה</div>
			
				<div class="master-content-wrapper g960" >
					

<header class="article-header cf ">
	
<script type="application/ld+json">
{
	"@context": "http://schema.org",
	"@type": "BreadcrumbList",
	"itemListElement": [
  {
    "@type": "ListItem",
    "position": 1,
    "item": {
      "@id": "/templates/articlecco_cdo/aid/6439348/jewish/Registration.htm",
      "name": "Registration"
    }
  },
  {
    "@type": "ListItem",
    "position": 2,
    "item": {
      "@id": "/article.asp?aid=6430169",
      "name": "Register for Summer 2026"
    }
  }
]
}
</script>
<div class="breadcrumbs breadcrumbs hide_for_print" data-list-name="breadcrumbs">
	
			<a class="breadcrumbs__crumb" href='/templates/articlecco_cdo/aid/6439348/jewish/Registration.htm' data-aid="6439348">
				Registration
			</a>
		
</div>
	
			<h1 class="article-header__title js-article-title js-page-title">Register for Summer 2026</h1>
		
			<div>
				
			</div>
		
</header>
				</div>
			
			<div class="body_wrapper clearfix co_body">
				<div class="g960" id="co_body_container">
					
					<div id="ContentBody">
						
						
							<div class="content-area-parent no_margin">
								
	<div id="cco_body">
		<div class="content g960 no_margin no_overflow" id="co_content_container">
			
			
	

	<article class="content js-content" >
	

<div id="formContainer"><script type="text/javascript">var defaultCurrency = { value: 'USD', symbol: '$'};
$j(function(){
window.multiplier = 0;
window.formJson = Object.extend([{"form_height":497,"1_text":"\u003cp\u003eCamp Gan Israel is a camp dedicated to enriching the lives of children from diverse Jewish backgrounds and affiliations through a stimulating camping experience. \u0026#160;CGI is part of the largest and fastest growing network of day camps, enjoying a reputation as a pioneer in Jewish camping, with innovative ideas and creative activities, to both provide enjoyment and inspire children to try new and exciting things!\u0026#160;\u003c/p\u003e","1_name":"doubleclickTo","1_qid":1,"1_type":"control_text","1_order":1,"15_text":"1. Family Information","15_subHeader":"","15_headerType":"Default","15_name":"clickTo15","15_qid":15,"15_type":"control_head","15_order":2,"134_text":"Mother\u0027s Name","134_message":"","134_labelAlign":"Auto","134_required":"Yes","134_prefix":"No","134_suffix":"No","134_middle":"No","134_description":"","134_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"134_readonly":"No","134_name":"fullName134","134_qid":134,"134_type":"control_fullname","134_order":3,"16_text":"Mother\u0027s Cell Number","16_message":"","16_labelAlign":"Auto","16_required":"Yes","16_validation":"Numeric","16_countryCode":"No","16_inputMask":"disable","16_inputMaskValue":"(###) ###-####","16_description":"","16_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"16_readonly":"No","16_name":"phoneNumber","16_qid":16,"16_type":"control_phone","16_order":4,"21_receivesReceipts":"Yes","21_text":"Mother\u0027s E-mail","21_message":"Primary email","21_labelAlign":"Auto","21_required":"Yes","21_size":30,"21_validation":"Email","21_maxsize":"","21_defaultValue":"","21_subLabel":"","21_hint":" ","21_description":"","21_confirmation":"No","21_confirmationHint":"Confirm Email","21_readonly":"No","21_name":"email","21_qid":21,"21_type":"control_email","21_order":5,"135_text":"Father\u0027s Name","135_message":"","135_labelAlign":"Auto","135_required":"Yes","135_prefix":"No","135_suffix":"No","135_middle":"No","135_description":"","135_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"135_readonly":"No","135_name":"fullName135","135_qid":135,"135_type":"control_fullname","135_order":6,"128_text":"Father\u0027s Cell Number","128_message":"","128_labelAlign":"Auto","128_required":"Yes","128_validation":"Numeric","128_countryCode":"No","128_inputMask":"disable","128_inputMaskValue":"(###) ###-####","128_description":"","128_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"128_readonly":"No","128_name":"phoneNumber128","128_qid":128,"128_type":"control_phone","128_order":7,"136_receivesReceipts":"Yes","136_text":"Father\u0027s E-mail","136_message":"Primary email","136_labelAlign":"Auto","136_required":"Yes","136_size":30,"136_validation":"Email","136_maxsize":"","136_defaultValue":"","136_subLabel":"","136_hint":" ","136_description":"","136_confirmation":"No","136_confirmationHint":"Confirm Email","136_readonly":"No","136_name":"email136","136_qid":136,"136_type":"control_email","136_order":8,"129_text":"Home Address","129_message":"Address where child resides","129_labelAlign":"Auto","129_required":"Yes","129_selectedCountry":"","129_description":"","129_subfields":"st1|st2|city|state|zip|country","129_sublabels":{"cc_firstName":"First Name","cc_lastName":"Last Name","cc_number":"Credit Card Number","cc_ccv":"Security Code","cc_exp_month":"Expiration Month","cc_exp_year":"Expiration Year","addr_line1":"Street Address","addr_line2":"Street Address Line 2","city":"City","state":"State / Province","postal":"Postal / Zip Code","country":"Country"},"129_name":"address129","129_qid":129,"129_type":"control_address","129_order":9,"137_text":"","137_message":"","137_labelAlign":"Auto","137_required":"No","137_options":"Add Address","137_special":"None","137_allowOther":"No","137_otherText":"Other","137_calculateOther":"No","137_spreadCols":"1","137_selected":"","137_minSelection":"","137_maxSelection":"","137_description":"","137_name":"input137","137_qid":137,"137_type":"control_checkbox","137_order":10,"138_text":"Address #2","138_message":"List the 2nd address only if child resides at this location.","138_labelAlign":"Auto","138_required":"No","138_selectedCountry":"","138_description":"","138_subfields":"st1|st2|city|state|zip|country","138_sublabels":{"cc_firstName":"First Name","cc_lastName":"Last Name","cc_number":"Credit Card Number","cc_ccv":"Security Code","cc_exp_month":"Expiration Month","cc_exp_year":"Expiration Year","addr_line1":"Street Address","addr_line2":"Street Address Line 2","city":"City","state":"State / Province","postal":"Postal / Zip Code","country":"Country"},"138_name":"address138","138_qid":138,"138_type":"control_address","138_order":11,"133_text":"Child/ren may be picked up from camp by:","133_message":"","133_labelAlign":"Auto","133_required":"No","133_cols":40,"133_rows":6,"133_validation":"None","133_entryLimit":"None-0","133_maxsize":"","133_defaultValue":"","133_subLabel":"List names and relationship","133_hint":"","133_description":"","133_readonly":"No","133_wysiwyg":"Disable","133_name":"input133","133_qid":133,"133_type":"control_textarea","133_order":12,"29_text":"Emergency Contact","29_message":"","29_labelAlign":"Auto","29_required":"Yes","29_prefix":"No","29_suffix":"No","29_middle":"No","29_description":"","29_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"29_readonly":"No","29_name":"fullName29","29_qid":29,"29_type":"control_fullname","29_order":13,"30_text":"Emergency Contact\u0027s Phone Number","30_message":"","30_labelAlign":"Auto","30_required":"Yes","30_validation":"Numeric","30_countryCode":"No","30_inputMask":"disable","30_inputMaskValue":"(###) ###-####","30_description":"","30_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"30_readonly":"No","30_name":"phoneNumber30","30_qid":30,"30_type":"control_phone","30_order":14,"31_text":"Relationship to Emergency Contact","31_message":"","31_labelAlign":"Auto","31_required":"Yes","31_size":20,"31_validation":"None","31_maxsize":"","31_inputTextMask":"","31_defaultValue":"","31_subLabel":"","31_hint":" ","31_description":"","31_readonly":"No","31_name":"input31","31_qid":31,"31_type":"control_textbox","31_order":15,"7_text":"2. Camper Information","7_subHeader":"","7_headerType":"Default","7_name":"clickTo","7_qid":7,"7_type":"control_head","7_order":16,"43_text":"Number of children being registered","43_message":"$50 non-refundable registration fee per child","43_labelAlign":"Auto","43_required":"Yes","43_size":"5","43_maxsize":"","43_minValue":"1","43_maxValue":"5","43_defaultValue":"","43_subLabel":"","43_hint":" ","43_description":"","43_readonly":"No","43_pricePerItem":50,"43_name":"number","43_qid":43,"43_type":"control_number","43_order":17,"44_text":"Child 1","44_subHeader":"","44_headerType":"Small","44_name":"clickTo44","44_qid":44,"44_type":"control_head","44_order":18,"78_text":"Full Name","78_message":"","78_labelAlign":"Auto","78_required":"Yes","78_prefix":"No","78_suffix":"No","78_middle":"No","78_description":"","78_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"78_readonly":"No","78_name":"fullName78","78_qid":78,"78_type":"control_fullname","78_order":19,"180_text":"Birth Date","180_message":"","180_labelAlign":"Auto","180_required":"Yes","180_format":"mmddyyyy","180_yearFrom":"","180_yearTo":"","180_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"180_description":"","180_sublabels":{"month":"Month","day":"Day","year":"Year"},"180_name":"birthDate","180_qid":180,"180_type":"control_birthdate","180_order":20,"181_text":"Hebrew Birthday","181_message":"","181_labelAlign":"Auto","181_required":"No","181_size":20,"181_validation":"None","181_maxsize":"","181_inputTextMask":"","181_defaultValue":"","181_subLabel":"","181_hint":" ","181_description":"","181_readonly":"No","181_name":"input181","181_qid":181,"181_type":"control_textbox","181_order":21,"182_text":"Insurance","182_message":"","182_labelAlign":"Auto","182_required":"Yes","182_size":20,"182_validation":"None","182_maxsize":"","182_inputTextMask":"","182_defaultValue":"","182_subLabel":"","182_hint":" ","182_description":"","182_readonly":"No","182_name":"input182","182_qid":182,"182_type":"control_textbox","182_order":22,"183_text":"Insurance ID#","183_message":"","183_labelAlign":"Auto","183_required":"Yes","183_size":20,"183_validation":"None","183_maxsize":"","183_inputTextMask":"","183_defaultValue":"","183_subLabel":"","183_hint":" ","183_description":"","183_readonly":"No","183_name":"input183","183_qid":183,"183_type":"control_textbox","183_order":23,"184_text":"T-shirt size","184_message":"","184_labelAlign":"Auto","184_required":"Yes","184_options":"XS|S|M|L|XL|S Adult","184_special":"None","184_allowOther":"Yes","184_otherText":"Other","184_calculateOther":"No","184_selected":"","184_spreadCols":"2","184_description":"","184_name":"input184","184_qid":184,"184_type":"control_radio","184_order":24,"72_text":"Child 2","72_subHeader":"","72_headerType":"Small","72_name":"clickTo72","72_qid":72,"72_type":"control_head","72_order":25,"3_text":"Full Name","3_message":"","3_labelAlign":"Auto","3_required":"Yes","3_prefix":"No","3_suffix":"No","3_middle":"No","3_description":"","3_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"3_readonly":"No","3_name":"fullName","3_qid":3,"3_type":"control_fullname","3_order":26,"168_text":"Birth Date","168_message":"","168_labelAlign":"Auto","168_required":"Yes","168_format":"mmddyyyy","168_yearFrom":"","168_yearTo":"","168_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"168_description":"","168_sublabels":{"month":"Month","day":"Day","year":"Year"},"168_name":"birthDate168","168_qid":168,"168_type":"control_birthdate","168_order":27,"86_text":"Hebrew Birthday","86_message":"","86_labelAlign":"Auto","86_required":"No","86_size":20,"86_validation":"None","86_maxsize":"","86_inputTextMask":"","86_defaultValue":"","86_subLabel":"","86_hint":" ","86_description":"","86_readonly":"No","86_name":"input86","86_qid":86,"86_type":"control_textbox","86_order":28,"151_text":"Insurance","151_message":"","151_labelAlign":"Auto","151_required":"Yes","151_size":20,"151_validation":"None","151_maxsize":"","151_inputTextMask":"","151_defaultValue":"","151_subLabel":"","151_hint":" ","151_description":"","151_readonly":"No","151_name":"input151","151_qid":151,"151_type":"control_textbox","151_order":29,"152_text":"Insurance ID#","152_message":"","152_labelAlign":"Auto","152_required":"Yes","152_size":20,"152_validation":"None","152_maxsize":"","152_inputTextMask":"","152_defaultValue":"","152_subLabel":"","152_hint":" ","152_description":"","152_readonly":"No","152_name":"input152","152_qid":152,"152_type":"control_textbox","152_order":30,"146_text":"T-shirt size","146_message":"","146_labelAlign":"Auto","146_required":"Yes","146_options":"XS|S|M|L|XL|S Adult","146_special":"None","146_allowOther":"Yes","146_otherText":"Other","146_calculateOther":"No","146_selected":"","146_spreadCols":"2","146_description":"","146_name":"input146","146_qid":146,"146_type":"control_radio","146_order":31,"73_text":"Child 3","73_subHeader":"","73_headerType":"Small","73_name":"clickTo73","73_qid":73,"73_type":"control_head","73_order":32,"79_text":"Full Name","79_message":"","79_labelAlign":"Auto","79_required":"Yes","79_prefix":"No","79_suffix":"No","79_middle":"No","79_description":"","79_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"79_readonly":"No","79_name":"fullName79","79_qid":79,"79_type":"control_fullname","79_order":33,"169_text":"Birth Date","169_message":"","169_labelAlign":"Auto","169_required":"Yes","169_format":"mmddyyyy","169_yearFrom":"","169_yearTo":"","169_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"169_description":"","169_sublabels":{"month":"Month","day":"Day","year":"Year"},"169_name":"birthDate169","169_qid":169,"169_type":"control_birthdate","169_order":34,"84_text":"Hebrew Birthday","84_message":"","84_labelAlign":"Auto","84_required":"No","84_size":20,"84_validation":"None","84_maxsize":"","84_inputTextMask":"","84_defaultValue":"","84_subLabel":"","84_hint":" ","84_description":"","84_readonly":"No","84_name":"input84","84_qid":84,"84_type":"control_textbox","84_order":35,"153_text":"Insurance","153_message":"","153_labelAlign":"Auto","153_required":"Yes","153_size":20,"153_validation":"None","153_maxsize":"","153_inputTextMask":"","153_defaultValue":"","153_subLabel":"","153_hint":" ","153_description":"","153_readonly":"No","153_name":"input153","153_qid":153,"153_type":"control_textbox","153_order":36,"154_text":"Insurance ID#","154_message":"","154_labelAlign":"Auto","154_required":"Yes","154_size":20,"154_validation":"None","154_maxsize":"","154_inputTextMask":"","154_defaultValue":"","154_subLabel":"","154_hint":" ","154_description":"","154_readonly":"No","154_name":"input154","154_qid":154,"154_type":"control_textbox","154_order":37,"147_text":"T-shirt size","147_message":"","147_labelAlign":"Auto","147_required":"Yes","147_options":"XS|S|M|L|XL|S Adult","147_special":"None","147_allowOther":"Yes","147_otherText":"Other","147_calculateOther":"No","147_selected":"","147_spreadCols":"2","147_description":"","147_name":"input147","147_qid":147,"147_type":"control_radio","147_order":38,"74_text":"Child 4","74_subHeader":"","74_headerType":"Small","74_name":"clickTo74","74_qid":74,"74_type":"control_head","74_order":39,"75_text":"Full Name","75_message":"","75_labelAlign":"Auto","75_required":"Yes","75_prefix":"No","75_suffix":"No","75_middle":"No","75_description":"","75_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"75_readonly":"No","75_name":"fullName75","75_qid":75,"75_type":"control_fullname","75_order":40,"170_text":"Birth Date","170_message":"","170_labelAlign":"Auto","170_required":"Yes","170_format":"mmddyyyy","170_yearFrom":"","170_yearTo":"","170_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"170_description":"","170_sublabels":{"month":"Month","day":"Day","year":"Year"},"170_name":"birthDate170","170_qid":170,"170_type":"control_birthdate","170_order":41,"85_text":"Hebrew Birthday","85_message":"","85_labelAlign":"Auto","85_required":"No","85_size":20,"85_validation":"None","85_maxsize":"","85_inputTextMask":"","85_defaultValue":"","85_subLabel":"","85_hint":" ","85_description":"","85_readonly":"No","85_name":"input85","85_qid":85,"85_type":"control_textbox","85_order":42,"156_text":"Insurance","156_message":"","156_labelAlign":"Auto","156_required":"Yes","156_size":20,"156_validation":"None","156_maxsize":"","156_inputTextMask":"","156_defaultValue":"","156_subLabel":"","156_hint":" ","156_description":"","156_readonly":"No","156_name":"input156","156_qid":156,"156_type":"control_textbox","156_order":43,"155_text":"Insurance ID#","155_message":"","155_labelAlign":"Auto","155_required":"Yes","155_size":20,"155_validation":"None","155_maxsize":"","155_inputTextMask":"","155_defaultValue":"","155_subLabel":"","155_hint":" ","155_description":"","155_readonly":"No","155_name":"input155","155_qid":155,"155_type":"control_textbox","155_order":44,"144_text":"T-shirt size","144_message":"","144_labelAlign":"Auto","144_required":"Yes","144_options":"XS|S|M|L|XL|S Adult","144_special":"None","144_allowOther":"Yes","144_otherText":"Other","144_calculateOther":"No","144_selected":"","144_spreadCols":"2","144_description":"","144_name":"input144","144_qid":144,"144_type":"control_radio","144_order":45,"172_text":"Child 5","172_subHeader":"","172_headerType":"Small","172_name":"clickTo172","172_qid":172,"172_type":"control_head","172_order":46,"173_text":"Full Name","173_message":"","173_labelAlign":"Auto","173_required":"Yes","173_prefix":"No","173_suffix":"No","173_middle":"No","173_description":"","173_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"173_readonly":"No","173_name":"fullName173","173_qid":173,"173_type":"control_fullname","173_order":47,"174_text":"Birth Date","174_message":"","174_labelAlign":"Auto","174_required":"Yes","174_format":"mmddyyyy","174_yearFrom":"","174_yearTo":"","174_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"174_description":"","174_sublabels":{"month":"Month","day":"Day","year":"Year"},"174_name":"birthDate174","174_qid":174,"174_type":"control_birthdate","174_order":48,"175_text":"Hebrew Birthday","175_message":"","175_labelAlign":"Auto","175_required":"No","175_size":20,"175_validation":"None","175_maxsize":"","175_inputTextMask":"","175_defaultValue":"","175_subLabel":"","175_hint":" ","175_description":"","175_readonly":"No","175_name":"input175","175_qid":175,"175_type":"control_textbox","175_order":49,"176_text":"Insurance","176_message":"","176_labelAlign":"Auto","176_required":"Yes","176_size":20,"176_validation":"None","176_maxsize":"","176_inputTextMask":"","176_defaultValue":"","176_subLabel":"","176_hint":" ","176_description":"","176_readonly":"No","176_name":"input176","176_qid":176,"176_type":"control_textbox","176_order":50,"177_text":"Insurance ID#","177_message":"","177_labelAlign":"Auto","177_required":"Yes","177_size":20,"177_validation":"None","177_maxsize":"","177_inputTextMask":"","177_defaultValue":"","177_subLabel":"","177_hint":" ","177_description":"","177_readonly":"No","177_name":"input177","177_qid":177,"177_type":"control_textbox","177_order":51,"178_text":"T-shirt size","178_message":"","178_labelAlign":"Auto","178_required":"Yes","178_options":"XS|S|M|L|XL|S Adult","178_special":"None","178_allowOther":"Yes","178_otherText":"Other","178_calculateOther":"No","178_selected":"","178_spreadCols":"2","178_description":"","178_name":"input178","178_qid":178,"178_type":"control_radio","178_order":52,"47_text":"3. Medical Information","47_subHeader":"","47_headerType":"Small","47_name":"clickTo47","47_qid":47,"47_type":"control_head","47_order":53,"32_text":"Pediatrician","32_message":"","32_labelAlign":"Auto","32_required":"Yes","32_prefix":"No","32_suffix":"No","32_middle":"No","32_description":"","32_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"32_readonly":"No","32_name":"fullName32","32_qid":32,"32_type":"control_fullname","32_order":54,"97_text":"Pediatrician\u0027s Phone Number","97_message":"","97_labelAlign":"Auto","97_required":"Yes","97_validation":"Numeric","97_countryCode":"No","97_inputMask":"disable","97_inputMaskValue":"(###) ###-####","97_description":"","97_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"97_readonly":"No","97_name":"phoneNumber97","97_qid":97,"97_type":"control_phone","97_order":55,"109_text":"Are your child/ren allergic to any foods? If yes, please explain","109_message":"","109_labelAlign":"Auto","109_required":"No","109_cols":40,"109_rows":6,"109_validation":"None","109_entryLimit":"None-0","109_maxsize":"","109_defaultValue":"","109_subLabel":"","109_hint":"","109_description":"","109_readonly":"No","109_wysiwyg":"Disable","109_name":"input109","109_qid":109,"109_type":"control_textarea","109_order":56,"111_text":"Are your child/ren up to date on all immunizations?","111_message":"","111_labelAlign":"Auto","111_required":"Yes","111_options":"Yes|No","111_special":"None","111_allowOther":"No","111_otherText":"Other","111_calculateOther":"No","111_selected":"","111_spreadCols":"1","111_description":"","111_name":"input111","111_qid":111,"111_type":"control_radio","111_order":57,"116_text":"Do your child/ren have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain","116_message":"","116_labelAlign":"Auto","116_required":"No","116_cols":40,"116_rows":6,"116_validation":"None","116_entryLimit":"None-0","116_maxsize":"","116_defaultValue":"","116_subLabel":"","116_hint":"","116_description":"","116_readonly":"No","116_wysiwyg":"Disable","116_name":"input116","116_qid":116,"116_type":"control_textarea","116_order":58,"124_text":"Are there any social or other challenges we should be aware of?","124_message":"","124_labelAlign":"Auto","124_required":"No","124_cols":40,"124_rows":6,"124_validation":"None","124_entryLimit":"None-0","124_maxsize":"","124_defaultValue":"","124_subLabel":"","124_hint":"","124_description":"","124_readonly":"No","124_wysiwyg":"Disable","124_name":"input124","124_qid":124,"124_type":"control_textarea","124_order":59,"64_text":"\u003cp\u003eI hereby give consent to the administration of Camp Gan Israel to take whatever medical measures they deem necessary, at my expense, for my child in the event of a medical emergency. I understand that, when possible, every effort will be made to contact parent/guardian or emergency contact before Camp Gan Israel will undertake such a decision.\u003c/p\u003e","64_name":"doubleclickTo64","64_qid":64,"64_type":"control_text","64_order":60,"65_text":"Signature of Parent or Guardian","65_message":"","65_labelAlign":"Auto","65_required":"Yes","65_size":20,"65_validation":"None","65_maxsize":"","65_inputTextMask":"","65_defaultValue":"","65_subLabel":"","65_hint":" ","65_description":"","65_readonly":"No","65_name":"input65","65_qid":65,"65_type":"control_textbox","65_order":61,"66_text":"Date \u0026amp; Time","66_message":"","66_labelAlign":"Auto","66_required":"Yes","66_format":"mmddyyyy","66_allowTime":"Yes","66_timeFormat":"AM/PM","66_showDayPeriods":"both","66_defaultTime":"Yes","66_onlyFuture":"No","66_step":"10","66_autoCalendar":"Yes","66_description":"","66_startWeekOn":"Sunday","66_sublabels":{"day":"Day","month":"Month","year":"Year","last":"Last Name","hour":"Hour","minutes":"Minutes"},"66_name":"input66","66_qid":66,"66_type":"control_datetime","66_order":62,"35_text":"4. Session Choice","35_subHeader":"","35_headerType":"Default","35_name":"clickTo35","35_qid":35,"35_type":"control_head","35_order":63,"157_text":"\u003cp\u003eCamp starts at 9:00. Early drop-off\u0026nbsp;\u003ci\u003e\u003cu\u003e(only for families who have pre-arranged with the Camp Director)\u003c/u\u003e\u003c/i\u003e\u0026nbsp;is at 8:30. Camp ends at 3:30 Monday-Thursday. Friday dismissal is at 2pm.\u003c/p\u003e\n\n\u003cp\u003e\u003cb\u003eCamp fees:\u0026nbsp;\u003c/b\u003e\u0026nbsp;$300 per camper per week.\u0026nbsp;Early bird (register by May 15th): $250 per camper per week\u0026nbsp;\u003c/p\u003e\n\n\u003cp\u003e\u003cb\u003eCGI Albany invests considerable resources and cuts no corners to ensure a first-rate experience for its campers. In spite of\u0026nbsp;continually rising costs in all areas, we have worked hard to offer an affordable\u0026nbsp;tuition\u0026nbsp;rate.\u003c/b\u003e\u003c/p\u003e\n\n\u003cp\u003e\u003cb\u003e\u003cu\u003eWe are proud of the fact that we have kept our\u003c/u\u003e\u003c/b\u003e\u003cb\u003e\u003cu\u003e\u0026nbsp;tuition well below the rate of other CGI\u0026#39;s and comparable programs\u003c/u\u003e\u003c/b\u003e\u003cb\u003e\u003cu\u003e. We hope these efforts are appreciated.\u003c/u\u003e\u003c/b\u003e\u003c/p\u003e\n\n\u003cp\u003e\u003cb\u003eFor financial question, please reach out to rabbimathless@gmail.com\u003c/b\u003e\u003c/p\u003e\n","157_name":"doubleclickTo157","157_qid":157,"157_type":"control_text","157_order":64,"88_text":"Please select the weeks that you plan your child(ren) will be participating in camp","88_message":"","88_labelAlign":"Auto","88_required":"Yes","88_options":"Week 1: July 7 - 10 (Note: As this is a Tuesday start, tuition will be prorated for this week)|Week 2: July 13-17|Week 3: July 20 - 24 (No camp on Tisha B\u0027Av, prorated)|Week 4: July 27 - July 31|Week 5: August 3-7|Week 6: August 10-14|Week 7: August 17-18 (prorated)","88_special":"None","88_allowOther":"No","88_otherText":"Other","88_calculateOther":"No","88_spreadCols":"1","88_selected":"","88_minSelection":"","88_maxSelection":"","88_description":"","88_name":"input88","88_qid":88,"88_type":"control_checkbox","88_order":65,"88_pricing":"0|0|0|0|0|0","159_text":"If different children will be attending for different weeks or you are not certain about some dates,  please specify\"","159_message":"","159_labelAlign":"Auto","159_required":"No","159_cols":40,"159_rows":6,"159_validation":"None","159_entryLimit":"None-0","159_maxsize":"","159_defaultValue":"","159_subLabel":"","159_hint":"","159_description":"","159_readonly":"No","159_wysiwyg":"Disable","159_name":"input159","159_qid":159,"159_type":"control_textarea","159_order":66,"158_text":"5. Payment Information","158_subHeader":"A $50 per child, non-refundable registration fee is required with registration. This will be deducted from your total camp tuition.","158_headerType":"Default","158_name":"clickTo158","158_qid":158,"158_type":"control_head","158_order":67,"37_labelAlign":"Auto","37_text":"Total","37_partialPayEnabled":"No","37_partialPayType":"percent","37_partialPayMinimum":"20","37_required":"No","37_offsetGiftEnabled":"No","37_offsetGift":3,"37_name":"total","37_qid":37,"37_type":"control_totalamount","37_order":68,"179_text":"Payment","179_message":"","179_labelAlign":"Auto","179_required":"Yes","179_duplicatable":false,"179_selectedCountry":"","179_description":"","179_sublabels":{"cc_firstName":"First Name","cc_lastName":"Last Name","cc_type":"Credit Card Type","cc_number":"Credit Card Number","cc_ccv":"Security Code","cc_nameOnCard":"Name on Card","cc_IdNumber":"Israel Identity Number","cc_exp_month":"Expiration Month","cc_exp_year":"Expiration Year","eCheck_bankName":"Bank Name","eCheck_routingNumber":"Routing Number","eCheck_accountNumber":"Account Number","eCheck_accountType":"Account Type","addr_line1":"Street Address","addr_line2":"Street Address Line 2","city":"City","state":"State / Province","postal":"Postal / Zip Code","country":"Country"},"179_name":"payment","179_qid":179,"179_type":"control_payform","179_order":69,"179_options":{"currency":"default","creditCard":{"value":"Credit Card","enabled":true,"fields":[{"name":"ccv","value":"CCV","enabled":true},{"name":"nameOnCard","value":"Name on Card","enabled":true},{"name":"billingAddress","value":"Billing Address","enabled":true},{"name":"israelIdentityNumber","value":"Israel Identity Number","enabled":true}],"processorIndex":2,"type":[{"name":"Visa","value":"Visa","enabled":true},{"name":"Mastercard","value":"MasterCard","enabled":true},{"name":"Amex","value":"American Express","enabled":true},{"name":"Discover","value":"Discover","enabled":true},{"name":"Isracard","value":"Isracard","enabled":false}],"payMe":false},"paypal":{"value":"Paypal","enabled":false,"processorIndex":null},"eCheck":{"value":"eCheck","enabled":false},"other":{"value":"Other","enabled":false,"altText":"","message":""}},"70_text":"Signature of Parent or Guardian","70_message":"","70_labelAlign":"Auto","70_required":"Yes","70_size":20,"70_validation":"None","70_maxsize":"","70_inputTextMask":"","70_defaultValue":"","70_subLabel":"","70_hint":" ","70_description":"","70_readonly":"No","70_name":"input70","70_qid":70,"70_type":"control_textbox","70_order":70,"71_text":"Date \u0026amp; Time","71_message":"","71_labelAlign":"Auto","71_required":"No","71_format":"mmddyyyy","71_allowTime":"Yes","71_timeFormat":"AM/PM","71_showDayPeriods":"both","71_defaultTime":"Yes","71_onlyFuture":"No","71_step":"10","71_autoCalendar":"Yes","71_description":"","71_startWeekOn":"Sunday","71_sublabels":{"day":"Day","month":"Month","year":"Year","last":"Last Name","hour":"Hour","minutes":"Minutes"},"71_name":"input71","71_qid":71,"71_type":"control_datetime","71_order":71,"39_text":"General comments","39_message":"","39_labelAlign":"Auto","39_required":"No","39_cols":40,"39_rows":6,"39_validation":"None","39_entryLimit":"None-0","39_maxsize":"","39_defaultValue":"","39_subLabel":"","39_hint":"","39_description":"","39_readonly":"No","39_wysiwyg":"Disable","39_name":"input39","39_qid":39,"39_type":"control_textarea","39_order":72,"form_title":"1. Child/ren’s Information","form_pagetitle":"Form","form_styles":"nova","form_font":"","form_fontsize":"14","form_fontcolor":"","form_optioncolor":"","form_lineSpacing":"12","form_background":"","form_formWidth":"685","form_labelWidth":"150","form_alignment":"Left","form_thankurl":"","form_thanktext":"","form_highlightLine":"Enabled","form_activeRedirect":"default","form_sendpostdata":"No","form_unique":"None","form_uniqueField":"\u003cField Id\u003e","form_status":"Enabled","form_injectCSS":"","form_hideMailEmptyFields":"disable","form_showProgressBar":"disable","form_formStrings":[{"alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","confirmClearForm":"Are you sure you want to clear the form?","confirmEmail":"E-mail does not match","email":"Enter a valid e-mail address","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxSelectionsError":"The maximum number of selections allowed is","minSelectionsError":"The minimum required number of selections is","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","numeric":"This field can only contain numeric values","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","submissionLimit":"Sorry! Only one entry is allowed. Multiple submissions are disabled for this form.","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:"}],"form_limitSubmission":"No Limit","form_expireDate":"No Limit","form_messageOfLimitedForm":"This form is currently unavailable!","form_emails":[],"form_language":"","form_sendEmail":"Yes","form_style":"Default","form_theme":"nova","form_id":6430169,"form_stopHighlight":"Yes","form_formStringsChanged":"yes","form_slug":6430169,"form_conditions":[{"type":"field","link":"Any","terms":[{"field":"137","operator":"isFilled","value":false}],"actions":[{"field":"138","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"1"}],"actions":[{"field":"72","visibility":"Show"},{"field":"3","visibility":"Show"},{"field":"168","visibility":"Show"},{"field":"86","visibility":"Show"},{"field":"151","visibility":"Show"},{"field":"152","visibility":"Show"},{"field":"146","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"2"}],"actions":[{"field":"73","visibility":"Show"},{"field":"79","visibility":"Show"},{"field":"169","visibility":"Show"},{"field":"84","visibility":"Show"},{"field":"153","visibility":"Show"},{"field":"154","visibility":"Show"},{"field":"147","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"3"}],"actions":[{"field":"74","visibility":"Show"},{"field":"75","visibility":"Show"},{"field":"170","visibility":"Show"},{"field":"85","visibility":"Show"},{"field":"156","visibility":"Show"},{"field":"155","visibility":"Show"},{"field":"144","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"4"}],"actions":[{"field":"172","visibility":"Show"},{"field":"173","visibility":"Show"},{"field":"174","visibility":"Show"},{"field":"175","visibility":"Show"},{"field":"176","visibility":"Show"},{"field":"177","visibility":"Show"},{"field":"178","visibility":"Show"}]}],"form_optinDisabled":"true","185_name":"submit","185_type":"control_button","185_qid":185,"185_order":73,"185_text":"Submit","185_buttonAlign":"Auto","185_clear":"No","185_print":"No"}][0] || {}, window.formJson || {});
window.isSecureForm = true
});

			if (typeof(Userform) ==='undefined')
			{
				Userform={init:function(args){
					$j(function(){
						Userform.init.apply(Userform, [args]);
					})
				},
				setConditions:function(args){
					$j(function(){
						Userform.setConditions.apply(Userform, [args]);
					})
				}};
			}
</script><script type="text/javascript">
   Userform.setConditions([{"type":"field","link":"Any","terms":[{"field":"137","operator":"isFilled","value":false}],"actions":[{"field":"138","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"1"}],"actions":[{"field":"72","visibility":"Show"},{"field":"3","visibility":"Show"},{"field":"168","visibility":"Show"},{"field":"86","visibility":"Show"},{"field":"151","visibility":"Show"},{"field":"152","visibility":"Show"},{"field":"146","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"2"}],"actions":[{"field":"73","visibility":"Show"},{"field":"79","visibility":"Show"},{"field":"169","visibility":"Show"},{"field":"84","visibility":"Show"},{"field":"153","visibility":"Show"},{"field":"154","visibility":"Show"},{"field":"147","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"3"}],"actions":[{"field":"74","visibility":"Show"},{"field":"75","visibility":"Show"},{"field":"170","visibility":"Show"},{"field":"85","visibility":"Show"},{"field":"156","visibility":"Show"},{"field":"155","visibility":"Show"},{"field":"144","visibility":"Show"}]},{"type":"field","link":"Any","terms":[{"field":"43","operator":"greaterThan","value":"4"}],"actions":[{"field":"172","visibility":"Show"},{"field":"173","visibility":"Show"},{"field":"174","visibility":"Show"},{"field":"175","visibility":"Show"},{"field":"176","visibility":"Show"},{"field":"177","visibility":"Show"},{"field":"178","visibility":"Show"}]}]);
   Userform.init(function(){
      Userform.setCalendar("66", false);
      Userform.displayLocalTime("hour_66", "min_66", "ampm_66");
      Userform.setCalendar("71", false);
      Userform.displayLocalTime("hour_71", "min_71", "ampm_71");
      Userform.alterTexts({"alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","confirmClearForm":"Are you sure you want to clear the form?","confirmEmail":"E-mail does not match","email":"Enter a valid e-mail address","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxSelectionsError":"The maximum number of selections allowed is","minSelectionsError":"The minimum required number of selections is","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","numeric":"This field can only contain numeric values","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","submissionLimit":"Sorry! Only one entry is allowed. Multiple submissions are disabled for this form.","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:"});
   });
</script>
<style type="text/css" id="GenFormStyles">
    .form-label{
        width:150px !important;
    }
    .form-label-left{
        width:150px !important;
    }
    .form-line{
        padding-top:12px;
        padding-bottom:12px;
    }
    .form-label-right{
        width:150px !important;
    }
    .form-all {
        font-size:14px;
    }
.co_body .content .form-all p {
 font-size:14px;

}
@media screen and (max-width: 600px) {.form-label-left{	float:none;	display:block;}.form-buttons-wrapper.button-align-auto{text-indent: 0!important;}}</style>

<form class="userform-form" action="" method="post" name="form_6430169" id="6430169" accept-charset="utf-8"><input type="hidden" name="formID" value="6430169" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li class="form-line" id="id_1"><div id="cid_1" class="form-input-wide"> <div id="text_1" class="form-html"><p>Camp Gan Israel is a camp dedicated to enriching the lives of children from diverse Jewish backgrounds and affiliations through a stimulating camping experience.  CGI is part of the largest and fastest growing network of day camps, enjoying a reputation as a pioneer in Jewish camping, with innovative ideas and creative activities, to both provide enjoyment and inspire children to try new and exciting things! </p></div> </div></li><li id="cid_15" class="form-input-wide"> <div class="form-header-group"><h2 id="header_15" class="form-header">1. Family Information</h2></div> </li><li class="form-line" id="id_134"><div class="form-label-left" id="label_134"><label for="input_134"> Mother's Name<span class="form-required">*</span> </label><label class="label-message" for="input_134"> </label></div><div id="cid_134" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q134_fullName134[first]" id="first_134" autocomplete="given-name" />  <label class="form-sub-label" for="first_134" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q134_fullName134[last]" id="last_134" autocomplete="family-name" />  <label class="form-sub-label" for="last_134" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_16"><div class="form-label-left" id="label_16"><label for="input_16"> Mother's Cell Number<span class="form-required">*</span> </label><label class="label-message" for="input_16"> </label></div><div id="cid_16" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q16_phoneNumber[area]" id="input_16_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_16_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q16_phoneNumber[phone]" id="input_16_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_16_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_21"><div class="form-label-left" id="label_21"><label for="input_21"> Mother's E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_21"> Primary email</label></div><div id="cid_21" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_21" name="q21_email" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_135"><div class="form-label-left" id="label_135"><label for="input_135"> Father's Name<span class="form-required">*</span> </label><label class="label-message" for="input_135"> </label></div><div id="cid_135" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q135_fullName135[first]" id="first_135" autocomplete="given-name" />  <label class="form-sub-label" for="first_135" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q135_fullName135[last]" id="last_135" autocomplete="family-name" />  <label class="form-sub-label" for="last_135" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_128"><div class="form-label-left" id="label_128"><label for="input_128"> Father's Cell Number<span class="form-required">*</span> </label><label class="label-message" for="input_128"> </label></div><div id="cid_128" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q128_phoneNumber128[area]" id="input_128_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_128_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q128_phoneNumber128[phone]" id="input_128_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_128_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_136"><div class="form-label-left" id="label_136"><label for="input_136"> Father's E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_136"> Primary email</label></div><div id="cid_136" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_136" name="q136_email136" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_129"><div class="form-label-left" id="label_129"><label for="input_129"> Home Address<span class="form-required">*</span> </label><label class="label-message" for="input_129"> Address where child resides</label></div><div id="cid_129" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q129_address129[addr_line1]" id="input_129_addr_line1" size="46" autocomplete="address-line1" />  <label class="form-sub-label" for="input_129_addr_line1" id="sublabel_129_addr_line1">Street Address</label></span></td></tr><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line no-validation" type="text" name="q129_address129[addr_line2]" id="input_129_addr_line2" size="46" autocomplete="address-line2" />  <label class="form-sub-label" for="input_129_addr_line2" id="sublabel_129_addr_line2">Street Address Line 2</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q129_address129[city]" id="input_129_city" size="21" autocomplete="address-level2" />  <label class="form-sub-label" for="input_129_city" id="sublabel_129_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q129_address129[state]" id="input_129_state" size="22" autocomplete="address-level1" />  <label class="form-sub-label" for="input_129_state" id="sublabel_129_state">State / Province</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q129_address129[postal]" id="input_129_postal" size="10" autocomplete="postal-code" />  <label class="form-sub-label" for="input_129_postal" id="sublabel_129_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q129_address129[country]" id="input_129_country" autocomplete="country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_129_country" id="sublabel_129_country">Country</label></span></td></tr></tbody></table> </div></li><li class="form-line" id="id_137"><div class="form-label-left" id="label_137"><label for="input_137">  </label><label class="label-message" for="input_137"> </label></div><div id="cid_137" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_137_0" name="q137_input137[]" value="Add Address" /><label id="label_input_137_0" for="input_137_0"><span>Add Address</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_138"><div class="form-label-left" id="label_138"><label for="input_138"> Address #2 </label><label class="label-message" for="input_138"> List the 2nd address only if child resides at this location.</label></div><div id="cid_138" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q138_address138[addr_line1]" id="input_138_addr_line1" size="46" autocomplete="address-line1" />  <label class="form-sub-label" for="input_138_addr_line1" id="sublabel_138_addr_line1">Street Address</label></span></td></tr><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line no-validation" type="text" name="q138_address138[addr_line2]" id="input_138_addr_line2" size="46" autocomplete="address-line2" />  <label class="form-sub-label" for="input_138_addr_line2" id="sublabel_138_addr_line2">Street Address Line 2</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-city" type="text" name="q138_address138[city]" id="input_138_city" size="21" autocomplete="address-level2" />  <label class="form-sub-label" for="input_138_city" id="sublabel_138_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox form-address-state" type="text" name="q138_address138[state]" id="input_138_state" size="22" autocomplete="address-level1" />  <label class="form-sub-label" for="input_138_state" id="sublabel_138_state">State / Province</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-postal" type="text" name="q138_address138[postal]" id="input_138_postal" size="10" autocomplete="postal-code" />  <label class="form-sub-label" for="input_138_postal" id="sublabel_138_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown form-address-country" name="q138_address138[country]" id="input_138_country" autocomplete="country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_138_country" id="sublabel_138_country">Country</label></span></td></tr></tbody></table> </div></li><li class="form-line" id="id_133"><div class="form-label-left" id="label_133"><label for="input_133"> Child/ren may be picked up from camp by: </label><label class="label-message" for="input_133"> </label></div><div id="cid_133" class="form-input"> <span class="form-sub-label-container"><textarea id="input_133" class="form-textarea" name="q133_input133" cols="40" rows="6"></textarea>  <label class="form-sub-label" for="input_133">List names and relationship</label></span> </div></li><li class="form-line" id="id_29"><div class="form-label-left" id="label_29"><label for="input_29"> Emergency Contact<span class="form-required">*</span> </label><label class="label-message" for="input_29"> </label></div><div id="cid_29" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q29_fullName29[first]" id="first_29" autocomplete="given-name" />  <label class="form-sub-label" for="first_29" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q29_fullName29[last]" id="last_29" autocomplete="family-name" />  <label class="form-sub-label" for="last_29" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_30"><div class="form-label-left" id="label_30"><label for="input_30"> Emergency Contact's Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_30"> </label></div><div id="cid_30" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q30_phoneNumber30[area]" id="input_30_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_30_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q30_phoneNumber30[phone]" id="input_30_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_30_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_31"><div class="form-label-left" id="label_31"><label for="input_31"> Relationship to Emergency Contact<span class="form-required">*</span> </label><label class="label-message" for="input_31"> </label></div><div id="cid_31" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_31" name="q31_input31" size="20" value="" /> </div></li><li id="cid_7" class="form-input-wide"> <div class="form-header-group"><h2 id="header_7" class="form-header">2. Camper Information</h2></div> </li><li class="form-line" id="id_43"><div class="form-label-left" id="label_43"><label for="input_43"> Number of children being registered<span class="form-required">*</span> </label><label class="label-message" for="input_43"> $50 non-refundable registration fee per child</label></div><div id="cid_43" class="form-input"> <input type="number" class="form-number-input  form-textbox validate[required]" id="input_43" name="q43_number" style="width:60px" size="5" value="" data-type="input-number" autocomplete="nope" min="1" data-numbermin="1" max="5" data-numbermax="5" /> </div></li><li id="cid_44" class="form-input-wide"> <div class="form-header-group"><h3 id="header_44" class="form-header">Child 1</h3></div> </li><li class="form-line" id="id_78"><div class="form-label-left" id="label_78"><label for="input_78"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_78"> </label></div><div id="cid_78" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q78_fullName78[first]" id="first_78" autocomplete="given-name" />  <label class="form-sub-label" for="first_78" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q78_fullName78[last]" id="last_78" autocomplete="family-name" />  <label class="form-sub-label" for="last_78" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_180"><div class="form-label-left" id="label_180"><label for="input_180"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_180"> </label></div><div id="cid_180" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q180_birthDate[month]" id="input_180_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_180_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q180_birthDate[day]" id="input_180_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_180_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q180_birthDate[year]" id="input_180_year"><option></option><option value="2026">2026</option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_180_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_181"><div class="form-label-left" id="label_181"><label for="input_181"> Hebrew Birthday </label><label class="label-message" for="input_181"> </label></div><div id="cid_181" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_181" name="q181_input181" size="20" value="" /> </div></li><li class="form-line" id="id_182"><div class="form-label-left" id="label_182"><label for="input_182"> Insurance<span class="form-required">*</span> </label><label class="label-message" for="input_182"> </label></div><div id="cid_182" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_182" name="q182_input182" size="20" value="" /> </div></li><li class="form-line" id="id_183"><div class="form-label-left" id="label_183"><label for="input_183"> Insurance ID#<span class="form-required">*</span> </label><label class="label-message" for="input_183"> </label></div><div id="cid_183" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_183" name="q183_input183" size="20" value="" /> </div></li><li class="form-line" id="id_184"><div class="form-label-left" id="label_184"><label for="input_184"> T-shirt size<span class="form-required">*</span> </label><label class="label-message" for="input_184"> </label></div><div id="cid_184" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_184_0" name="q184_input184" value="XS" /><label id="label_input_184_0" for="input_184_0"><span>XS</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_184_1" name="q184_input184" value="S" /><label id="label_input_184_1" for="input_184_1"><span>S</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_184_2" name="q184_input184" value="M" /><label id="label_input_184_2" for="input_184_2"><span>M</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_184_3" name="q184_input184" value="L" /><label id="label_input_184_3" for="input_184_3"><span>L</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_184_4" name="q184_input184" value="XL" /><label id="label_input_184_4" for="input_184_4"><span>XL</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_184_5" name="q184_input184" value="S Adult" /><label id="label_input_184_5" for="input_184_5"><span>S Adult</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required, other]" name="q184_input184" id="other_184" value="" /><span><input type="text" class="form-radio-other-input form-textbox form-radio validate[required, other]" name="q184_input184[other]" data-otherhint="Other" size="15" id="input_184" disabled="disabled" /></span><br /></span></div> </div></li><li id="cid_72" class="form-input-wide"> <div class="form-header-group"><h3 id="header_72" class="form-header">Child 2</h3></div> </li><li class="form-line" id="id_3"><div class="form-label-left" id="label_3"><label for="input_3"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_3"> </label></div><div id="cid_3" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q3_fullName[first]" id="first_3" autocomplete="given-name" />  <label class="form-sub-label" for="first_3" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q3_fullName[last]" id="last_3" autocomplete="family-name" />  <label class="form-sub-label" for="last_3" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_168"><div class="form-label-left" id="label_168"><label for="input_168"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_168"> </label></div><div id="cid_168" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q168_birthDate168[month]" id="input_168_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_168_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q168_birthDate168[day]" id="input_168_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_168_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q168_birthDate168[year]" id="input_168_year"><option></option><option value="2026">2026</option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_168_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_86"><div class="form-label-left" id="label_86"><label for="input_86"> Hebrew Birthday </label><label class="label-message" for="input_86"> </label></div><div id="cid_86" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_86" name="q86_input86" size="20" value="" /> </div></li><li class="form-line" id="id_151"><div class="form-label-left" id="label_151"><label for="input_151"> Insurance<span class="form-required">*</span> </label><label class="label-message" for="input_151"> </label></div><div id="cid_151" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_151" name="q151_input151" size="20" value="" /> </div></li><li class="form-line" id="id_152"><div class="form-label-left" id="label_152"><label for="input_152"> Insurance ID#<span class="form-required">*</span> </label><label class="label-message" for="input_152"> </label></div><div id="cid_152" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_152" name="q152_input152" size="20" value="" /> </div></li><li class="form-line" id="id_146"><div class="form-label-left" id="label_146"><label for="input_146"> T-shirt size<span class="form-required">*</span> </label><label class="label-message" for="input_146"> </label></div><div id="cid_146" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_146_0" name="q146_input146" value="XS" /><label id="label_input_146_0" for="input_146_0"><span>XS</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_146_1" name="q146_input146" value="S" /><label id="label_input_146_1" for="input_146_1"><span>S</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_146_2" name="q146_input146" value="M" /><label id="label_input_146_2" for="input_146_2"><span>M</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_146_3" name="q146_input146" value="L" /><label id="label_input_146_3" for="input_146_3"><span>L</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_146_4" name="q146_input146" value="XL" /><label id="label_input_146_4" for="input_146_4"><span>XL</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_146_5" name="q146_input146" value="S Adult" /><label id="label_input_146_5" for="input_146_5"><span>S Adult</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required, other]" name="q146_input146" id="other_146" value="" /><span><input type="text" class="form-radio-other-input form-textbox form-radio validate[required, other]" name="q146_input146[other]" data-otherhint="Other" size="15" id="input_146" disabled="disabled" /></span><br /></span></div> </div></li><li id="cid_73" class="form-input-wide"> <div class="form-header-group"><h3 id="header_73" class="form-header">Child 3</h3></div> </li><li class="form-line" id="id_79"><div class="form-label-left" id="label_79"><label for="input_79"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_79"> </label></div><div id="cid_79" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q79_fullName79[first]" id="first_79" autocomplete="given-name" />  <label class="form-sub-label" for="first_79" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q79_fullName79[last]" id="last_79" autocomplete="family-name" />  <label class="form-sub-label" for="last_79" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_169"><div class="form-label-left" id="label_169"><label for="input_169"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_169"> </label></div><div id="cid_169" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q169_birthDate169[month]" id="input_169_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_169_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q169_birthDate169[day]" id="input_169_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_169_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q169_birthDate169[year]" id="input_169_year"><option></option><option value="2026">2026</option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_169_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_84"><div class="form-label-left" id="label_84"><label for="input_84"> Hebrew Birthday </label><label class="label-message" for="input_84"> </label></div><div id="cid_84" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_84" name="q84_input84" size="20" value="" /> </div></li><li class="form-line" id="id_153"><div class="form-label-left" id="label_153"><label for="input_153"> Insurance<span class="form-required">*</span> </label><label class="label-message" for="input_153"> </label></div><div id="cid_153" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_153" name="q153_input153" size="20" value="" /> </div></li><li class="form-line" id="id_154"><div class="form-label-left" id="label_154"><label for="input_154"> Insurance ID#<span class="form-required">*</span> </label><label class="label-message" for="input_154"> </label></div><div id="cid_154" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_154" name="q154_input154" size="20" value="" /> </div></li><li class="form-line" id="id_147"><div class="form-label-left" id="label_147"><label for="input_147"> T-shirt size<span class="form-required">*</span> </label><label class="label-message" for="input_147"> </label></div><div id="cid_147" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_147_0" name="q147_input147" value="XS" /><label id="label_input_147_0" for="input_147_0"><span>XS</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_147_1" name="q147_input147" value="S" /><label id="label_input_147_1" for="input_147_1"><span>S</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_147_2" name="q147_input147" value="M" /><label id="label_input_147_2" for="input_147_2"><span>M</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_147_3" name="q147_input147" value="L" /><label id="label_input_147_3" for="input_147_3"><span>L</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_147_4" name="q147_input147" value="XL" /><label id="label_input_147_4" for="input_147_4"><span>XL</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_147_5" name="q147_input147" value="S Adult" /><label id="label_input_147_5" for="input_147_5"><span>S Adult</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required, other]" name="q147_input147" id="other_147" value="" /><span><input type="text" class="form-radio-other-input form-textbox form-radio validate[required, other]" name="q147_input147[other]" data-otherhint="Other" size="15" id="input_147" disabled="disabled" /></span><br /></span></div> </div></li><li id="cid_74" class="form-input-wide"> <div class="form-header-group"><h3 id="header_74" class="form-header">Child 4</h3></div> </li><li class="form-line" id="id_75"><div class="form-label-left" id="label_75"><label for="input_75"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_75"> </label></div><div id="cid_75" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q75_fullName75[first]" id="first_75" autocomplete="given-name" />  <label class="form-sub-label" for="first_75" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q75_fullName75[last]" id="last_75" autocomplete="family-name" />  <label class="form-sub-label" for="last_75" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_170"><div class="form-label-left" id="label_170"><label for="input_170"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_170"> </label></div><div id="cid_170" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q170_birthDate170[month]" id="input_170_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_170_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q170_birthDate170[day]" id="input_170_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_170_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q170_birthDate170[year]" id="input_170_year"><option></option><option value="2026">2026</option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_170_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_85"><div class="form-label-left" id="label_85"><label for="input_85"> Hebrew Birthday </label><label class="label-message" for="input_85"> </label></div><div id="cid_85" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_85" name="q85_input85" size="20" value="" /> </div></li><li class="form-line" id="id_156"><div class="form-label-left" id="label_156"><label for="input_156"> Insurance<span class="form-required">*</span> </label><label class="label-message" for="input_156"> </label></div><div id="cid_156" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_156" name="q156_input156" size="20" value="" /> </div></li><li class="form-line" id="id_155"><div class="form-label-left" id="label_155"><label for="input_155"> Insurance ID#<span class="form-required">*</span> </label><label class="label-message" for="input_155"> </label></div><div id="cid_155" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_155" name="q155_input155" size="20" value="" /> </div></li><li class="form-line" id="id_144"><div class="form-label-left" id="label_144"><label for="input_144"> T-shirt size<span class="form-required">*</span> </label><label class="label-message" for="input_144"> </label></div><div id="cid_144" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_144_0" name="q144_input144" value="XS" /><label id="label_input_144_0" for="input_144_0"><span>XS</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_144_1" name="q144_input144" value="S" /><label id="label_input_144_1" for="input_144_1"><span>S</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_144_2" name="q144_input144" value="M" /><label id="label_input_144_2" for="input_144_2"><span>M</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_144_3" name="q144_input144" value="L" /><label id="label_input_144_3" for="input_144_3"><span>L</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_144_4" name="q144_input144" value="XL" /><label id="label_input_144_4" for="input_144_4"><span>XL</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_144_5" name="q144_input144" value="S Adult" /><label id="label_input_144_5" for="input_144_5"><span>S Adult</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required, other]" name="q144_input144" id="other_144" value="" /><span><input type="text" class="form-radio-other-input form-textbox form-radio validate[required, other]" name="q144_input144[other]" data-otherhint="Other" size="15" id="input_144" disabled="disabled" /></span><br /></span></div> </div></li><li id="cid_172" class="form-input-wide"> <div class="form-header-group"><h3 id="header_172" class="form-header">Child 5</h3></div> </li><li class="form-line" id="id_173"><div class="form-label-left" id="label_173"><label for="input_173"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_173"> </label></div><div id="cid_173" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q173_fullName173[first]" id="first_173" autocomplete="given-name" />  <label class="form-sub-label" for="first_173" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q173_fullName173[last]" id="last_173" autocomplete="family-name" />  <label class="form-sub-label" for="last_173" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_174"><div class="form-label-left" id="label_174"><label for="input_174"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_174"> </label></div><div id="cid_174" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q174_birthDate174[month]" id="input_174_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_174_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q174_birthDate174[day]" id="input_174_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_174_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" name="q174_birthDate174[year]" id="input_174_year"><option></option><option value="2026">2026</option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_174_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_175"><div class="form-label-left" id="label_175"><label for="input_175"> Hebrew Birthday </label><label class="label-message" for="input_175"> </label></div><div id="cid_175" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_175" name="q175_input175" size="20" value="" /> </div></li><li class="form-line" id="id_176"><div class="form-label-left" id="label_176"><label for="input_176"> Insurance<span class="form-required">*</span> </label><label class="label-message" for="input_176"> </label></div><div id="cid_176" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_176" name="q176_input176" size="20" value="" /> </div></li><li class="form-line" id="id_177"><div class="form-label-left" id="label_177"><label for="input_177"> Insurance ID#<span class="form-required">*</span> </label><label class="label-message" for="input_177"> </label></div><div id="cid_177" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_177" name="q177_input177" size="20" value="" /> </div></li><li class="form-line" id="id_178"><div class="form-label-left" id="label_178"><label for="input_178"> T-shirt size<span class="form-required">*</span> </label><label class="label-message" for="input_178"> </label></div><div id="cid_178" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_178_0" name="q178_input178" value="XS" /><label id="label_input_178_0" for="input_178_0"><span>XS</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_178_1" name="q178_input178" value="S" /><label id="label_input_178_1" for="input_178_1"><span>S</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_178_2" name="q178_input178" value="M" /><label id="label_input_178_2" for="input_178_2"><span>M</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_178_3" name="q178_input178" value="L" /><label id="label_input_178_3" for="input_178_3"><span>L</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_178_4" name="q178_input178" value="XL" /><label id="label_input_178_4" for="input_178_4"><span>XL</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_178_5" name="q178_input178" value="S Adult" /><label id="label_input_178_5" for="input_178_5"><span>S Adult</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required, other]" name="q178_input178" id="other_178" value="" /><span><input type="text" class="form-radio-other-input form-textbox form-radio validate[required, other]" name="q178_input178[other]" data-otherhint="Other" size="15" id="input_178" disabled="disabled" /></span><br /></span></div> </div></li><li id="cid_47" class="form-input-wide"> <div class="form-header-group"><h3 id="header_47" class="form-header">3. Medical Information</h3></div> </li><li class="form-line" id="id_32"><div class="form-label-left" id="label_32"><label for="input_32"> Pediatrician<span class="form-required">*</span> </label><label class="label-message" for="input_32"> </label></div><div id="cid_32" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q32_fullName32[first]" id="first_32" autocomplete="given-name" />  <label class="form-sub-label" for="first_32" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q32_fullName32[last]" id="last_32" autocomplete="family-name" />  <label class="form-sub-label" for="last_32" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_97"><div class="form-label-left" id="label_97"><label for="input_97"> Pediatrician's Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_97"> </label></div><div id="cid_97" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q97_phoneNumber97[area]" id="input_97_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_97_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q97_phoneNumber97[phone]" id="input_97_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_97_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_109"><div class="form-label-left" id="label_109"><label for="input_109"> Are your child/ren allergic to any foods? If yes, please explain </label><label class="label-message" for="input_109"> </label></div><div id="cid_109" class="form-input"> <textarea id="input_109" class="form-textarea" name="q109_input109" cols="40" rows="6"></textarea> </div></li><li class="form-line" id="id_111"><div class="form-label-left" id="label_111"><label for="input_111"> Are your child/ren up to date on all immunizations?<span class="form-required">*</span> </label><label class="label-message" for="input_111"> </label></div><div id="cid_111" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_111_0" name="q111_input111" value="Yes" /><label id="label_input_111_0" for="input_111_0"><span>Yes</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_111_1" name="q111_input111" value="No" /><label id="label_input_111_1" for="input_111_1"><span>No</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_116"><div class="form-label-left" id="label_116"><label for="input_116"> Do your child/ren have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain </label><label class="label-message" for="input_116"> </label></div><div id="cid_116" class="form-input"> <textarea id="input_116" class="form-textarea" name="q116_input116" cols="40" rows="6"></textarea> </div></li><li class="form-line" id="id_124"><div class="form-label-left" id="label_124"><label for="input_124"> Are there any social or other challenges we should be aware of? </label><label class="label-message" for="input_124"> </label></div><div id="cid_124" class="form-input"> <textarea id="input_124" class="form-textarea" name="q124_input124" cols="40" rows="6"></textarea> </div></li><li class="form-line" id="id_64"><div id="cid_64" class="form-input-wide"> <div id="text_64" class="form-html"><p>I hereby give consent to the administration of Camp Gan Israel to take whatever medical measures they deem necessary, at my expense, for my child in the event of a medical emergency. I understand that, when possible, every effort will be made to contact parent/guardian or emergency contact before Camp Gan Israel will undertake such a decision.</p></div> </div></li><li class="form-line" id="id_65"><div class="form-label-left" id="label_65"><label for="input_65"> Signature of Parent or Guardian<span class="form-required">*</span> </label><label class="label-message" for="input_65"> </label></div><div id="cid_65" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_65" name="q65_input65" size="20" value="" /> </div></li><li class="form-line" id="id_66"><div class="form-label-left" id="label_66"><label for="input_66"> Date &amp; Time<span class="form-required">*</span> </label><label class="label-message" for="input_66"> </label></div><div id="cid_66" class="form-input"> <div class="datetime-fields"><div class="dir_ltr date-fields"><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox validate[required]" id="month_66" name="q66_input66[month]" type="tel" size="2" maxlength="2" value="03" />  <label class="form-sub-label" for="month_66" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox validate[required]" id="day_66" name="q66_input66[day]" type="tel" size="2" maxlength="2" value="17" />  <label class="form-sub-label" for="day_66" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox validate[required]" id="year_66" name="q66_input66[year]" type="tel" size="4" maxlength="4" value="2026" />  <label class="form-sub-label" for="year_66" id="sublabel_year">Year</label></span><span class="form-sub-label-container"><img class="showAutoCalendar" alt="Pick a Date" id="input_66_pick" src="https://w2.chabad.org/images/sitecontrol/formbuilder/calendar.png" align="absmiddle" />  <label class="form-sub-label" for="input_66_pick"><span> </span></label></span></div><span class="dir_ltr inline_block time-fields" style="white-space: nowrap;"><span class="form-sub-label-container"><span id="at_66" class="form-control-static at-label">at</span>  <label class="form-sub-label" for="at_66"><span> </span></label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown validate[required]" id="hour_66" name="q66_input66[hour]"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option selected="selected" value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option></select>  <label class="form-sub-label" for="hour_66" id="sublabel_hour">Hour</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" id="min_66" name="q66_input66[min]"><option></option><option value="00">00</option><option value="10">10</option><option selected="selected" value="20">20</option><option value="30">30</option><option value="40">40</option><option value="50">50</option></select>  <label class="form-sub-label" for="min_66" id="sublabel_minutes">Minutes</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" id="ampm_66" name="q66_input66[ampm]"><option value="AM">AM</option><option selected="selected" value="PM">PM</option></select>  <label class="form-sub-label" for="ampm_66"><span> </span></label></span></span></div> </div></li><li id="cid_35" class="form-input-wide"> <div class="form-header-group"><h2 id="header_35" class="form-header">4. Session Choice</h2></div> </li><li class="form-line" id="id_157"><div id="cid_157" class="form-input-wide"> <div id="text_157" class="form-html"><p>Camp starts at 9:00. Early drop-off <i><u>(only for families who have pre-arranged with the Camp Director)</u></i> is at 8:30. Camp ends at 3:30 Monday-Thursday. Friday dismissal is at 2pm.</p>

<p><b>Camp fees: </b> $300 per camper per week. Early bird (register by May 15th): $250 per camper per week </p>

<p><b>CGI Albany invests considerable resources and cuts no corners to ensure a first-rate experience for its campers. In spite of continually rising costs in all areas, we have worked hard to offer an affordable tuition rate.</b></p>

<p><b><u>We are proud of the fact that we have kept our</u></b><b><u> tuition well below the rate of other CGI's and comparable programs</u></b><b><u>. We hope these efforts are appreciated.</u></b></p>

<p><b>For financial question, please reach out to rabbimathless@gmail.com</b></p>
</div> </div></li><li class="form-line" id="id_88"><div class="form-label-left" id="label_88"><label for="input_88"> Please select the weeks that you plan your child(ren) will be participating in camp<span class="form-required">*</span> </label><label class="label-message" for="input_88"> </label></div><div id="cid_88" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_88_0" name="q88_input88[]" value="Week 1: July 7 - 10 (Note: As this is a Tuesday start, tuition will be prorated for this week)" /><label id="label_input_88_0" for="input_88_0"><span>Week 1: July 7 - 10 (Note: As this is a Tuesday start, tuition will be prorated for this week)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_88_1" name="q88_input88[]" value="Week 2: July 13-17" /><label id="label_input_88_1" for="input_88_1"><span>Week 2: July 13-17</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_88_2" name="q88_input88[]" value="Week 3: July 20 - 24 (No camp on Tisha B'Av, prorated)" /><label id="label_input_88_2" for="input_88_2"><span>Week 3: July 20 - 24 (No camp on Tisha B'Av, prorated)</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_88_3" name="q88_input88[]" value="Week 4: July 27 - July 31" /><label id="label_input_88_3" for="input_88_3"><span>Week 4: July 27 - July 31</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_88_4" name="q88_input88[]" value="Week 5: August 3-7" /><label id="label_input_88_4" for="input_88_4"><span>Week 5: August 3-7</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_88_5" name="q88_input88[]" value="Week 6: August 10-14" /><label id="label_input_88_5" for="input_88_5"><span>Week 6: August 10-14</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_88_6" name="q88_input88[]" value="Week 7: August 17-18 (prorated)" /><label id="label_input_88_6" for="input_88_6"><span>Week 7: August 17-18 (prorated)</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_159"><div class="form-label-left" id="label_159"><label for="input_159"> If different children will be attending for different weeks or you are not certain about some dates,  please specify" </label><label class="label-message" for="input_159"> </label></div><div id="cid_159" class="form-input"> <textarea id="input_159" class="form-textarea" name="q159_input159" cols="40" rows="6"></textarea> </div></li><li id="cid_158" class="form-input-wide"> <div class="form-header-group"><h2 id="header_158" class="form-header">5. Payment Information</h2><div id="subHeader_158" class="form-subHeader">A $50 per child, non-refundable registration fee is required with registration. This will be deducted from your total camp tuition.</div></div> </li><li class="form-line" id="id_37"><div class="form-label-left" id="label_37"><label for="input_37"> Total </label></div><div id="cid_37" class="form-input"> <div id="total_amount">$0.00 </div> </div></li><li class="form-line" id="id_179"><div class="form-label-left" id="label_179"><label for="input_179"> Payment<span class="form-required">*</span> </label><label class="label-message" for="input_179"> </label></div><div id="cid_179" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2" class="form-payment-methods form-multiple-column"></td></tr><tr class="credit_card "><th colspan="2">Credit Card</th></tr><tr class="credit_card "><td colspan="2" style="padding:0"><table cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container">  <label class="form-sub-label">We accept Visa, MasterCard, American Express, Discover</label></span><div class="cc-icons"><div class="cc-icon visa-icon"></div><div class="cc-icon mastercard-icon"></div><div class="cc-icon amex-icon"></div><div class="cc-icon discover-icon"></div></div><input type="hidden" name="q179_payment[cc_type]" id="input_179_cc_type" value="" /></td></tr><tr><td><div class="cc-field-wrapper"><span class="form-sub-label-container"><input class="form-textbox form-creditcard js-cc-number validate[required, visible, creditcard]" type="text" name="q179_payment[cc_number]" id="input_179_cc_number" autocomplete="cc-number" size="20" />  <label class="form-sub-label" for="input_179_cc_number" id="sublabel_cc_number">Credit Card Number</label></span></div></td><td class="cc_ccv "><span class="form-sub-label-container"><input class="form-textbox validate[required, visible]" type="text" name="q179_payment[cc_ccv]" id="input_179_cc_ccv" autocomplete="cc-csc" size="6" />  <label class="form-sub-label" for="input_179_cc_ccv" id="sublabel_cc_ccv">Security Code</label></span></td></tr><tr><td colspan="2" class="cc_name_on_card "><span class="form-sub-label-container"><input class="form-textbox validate[required, visible]" type="text" name="q179_payment[cc_nameOnCard]" id="input_179_cc_nameOnCard" autocomplete="cc-name" size="33" />  <label class="form-sub-label" for="input_179_cc_nameOnCard" id="sublabel_cc_nameOnCard">Name on Card</label></span></td></tr><tr class="credit_card "><td colspan=""><span class="form-sub-label-container"><select class="form-textbox validate[required, visible]" name="q179_payment[cc_exp_month]" id="input_179_cc_exp_month" autocomplete="cc-exp-month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_179_cc_exp_month" id="sublabel_cc_exp_month">Expiration Month</label></span></td><td><span class="form-sub-label-container"><select class="form-textbox validate[required, visible]" name="q179_payment[cc_exp_year]" id="input_179_cc_exp_year" autocomplete="cc-exp-year"><option></option><option value="2026">2026</option><option value="2027">2027</option><option value="2028">2028</option><option value="2029">2029</option><option value="2030">2030</option><option value="2031">2031</option><option value="2032">2032</option><option value="2033">2033</option><option value="2034">2034</option><option value="2035">2035</option></select>  <label class="form-sub-label" for="input_179_cc_exp_year" id="sublabel_cc_exp_year">Expiration Year</label></span></td></tr></tbody></table></td></tr><tr class="billing_address "><th colspan="2">Billing Address</th></tr><tr class="billing_address "><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q179_payment[addr_line1]" id="input_179_addr_line1" autocomplete="billing address-line1" />  <label class="form-sub-label" for="input_179_addr_line1" id="sublabel_179_addr_line1">Street Address</label></span></td></tr><tr class="billing_address "><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q179_payment[city]" id="input_179_city" autocomplete="billing address-level2" />  <label class="form-sub-label" for="input_179_city" id="sublabel_179_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q179_payment[state]" id="input_179_state" autocomplete="billing address-level1" />  <label class="form-sub-label" for="input_179_state" id="sublabel_179_state">State / Province</label></span></td></tr><tr class="billing_address "><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q179_payment[postal]" id="input_179_postal" size="10" autocomplete="billing postal-code" />  <label class="form-sub-label" for="input_179_postal" id="sublabel_179_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q179_payment[country]" id="input_179_country" autocomplete="billing country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_179_country" id="sublabel_179_country">Country</label></span></td></tr></tbody></table> </div></li><li class="form-line" id="id_70"><div class="form-label-left" id="label_70"><label for="input_70"> Signature of Parent or Guardian<span class="form-required">*</span> </label><label class="label-message" for="input_70"> </label></div><div id="cid_70" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_70" name="q70_input70" size="20" value="" /> </div></li><li class="form-line" id="id_71"><div class="form-label-left" id="label_71"><label for="input_71"> Date &amp; Time </label><label class="label-message" for="input_71"> </label></div><div id="cid_71" class="form-input"> <div class="datetime-fields"><div class="dir_ltr date-fields"><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox" id="month_71" name="q71_input71[month]" type="tel" size="2" maxlength="2" value="03" />  <label class="form-sub-label" for="month_71" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox" id="day_71" name="q71_input71[day]" type="tel" size="2" maxlength="2" value="17" />  <label class="form-sub-label" for="day_71" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox" id="year_71" name="q71_input71[year]" type="tel" size="4" maxlength="4" value="2026" />  <label class="form-sub-label" for="year_71" id="sublabel_year">Year</label></span><span class="form-sub-label-container"><img class="showAutoCalendar" alt="Pick a Date" id="input_71_pick" src="https://w2.chabad.org/images/sitecontrol/formbuilder/calendar.png" align="absmiddle" />  <label class="form-sub-label" for="input_71_pick"><span> </span></label></span></div><span class="dir_ltr inline_block time-fields" style="white-space: nowrap;"><span class="form-sub-label-container"><span id="at_71" class="form-control-static at-label">at</span>  <label class="form-sub-label" for="at_71"><span> </span></label></span><span class="form-sub-label-container"><select autocomplete="nope" class="form-dropdown" id="hour_71" name="q71_input71[hour]"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option selected="selected" value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option></select>  <label class="form-sub-label" for="hour_71" id="sublabel_hour">Hour</label></span><span class="form-sub-label-container"><select class="form-dropdown" id="min_71" name="q71_input71[min]"><option></option><option value="00">00</option><option value="10">10</option><option selected="selected" value="20">20</option><option value="30">30</option><option value="40">40</option><option value="50">50</option></select>  <label class="form-sub-label" for="min_71" id="sublabel_minutes">Minutes</label></span><span class="form-sub-label-container"><select class="form-dropdown" id="ampm_71" name="q71_input71[ampm]"><option value="AM">AM</option><option selected="selected" value="PM">PM</option></select>  <label class="form-sub-label" for="ampm_71"><span> </span></label></span></span></div> </div></li><li class="form-line" id="id_39"><div class="form-label-left" id="label_39"><label for="input_39"> General comments </label><label class="label-message" for="input_39"> </label></div><div id="cid_39" class="form-input"> <textarea id="input_39" class="form-textarea" name="q39_input39" cols="40" rows="6"></textarea> </div></li><li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li><li class="form-line" id="id_185"><div id="cid_185" class="form-input-wide"><div style="text-align:center" class="form-buttons-wrapper"><button id="input_185" type="submit" class="form-submit-button form-submit-button-none;">Submit</button></div></div></li></ul></div><input type="hidden" id="simple_spc" name="simple_spc" value="6430169" /><script type="text/javascript">document.getElementById("si"+"mple"+"_spc").value = "6430169-6430169";</script><div>


<script>
	var recaptchaIsEnterprise = false;
		 var recaptchaV2Key = "6LcG_TcUAAAAAKAVgwgW39ujc9OCjXSoQYFIA-Su";

</script>

	<input type="hidden" class="js-recaptcha-input" name="cdo-captcha-response" value="" data-div-id="fb529945-07b9-4d0e-9e14-8e656b000c87" data-processed="false" />
	<div class="js-recaptcha-wrapper" id="fb529945-07b9-4d0e-9e14-8e656b000c87"></div>	
</div></form></div>
<div class="center small">
	<img valign="absbottom" src="https://w2.chabad.org/images/global/icons/lock.gif" width="16" height="16" alt="Secure"> This page uses TLS encryption to keep your data secure.
</div>
	<div class="break_floats"></div>
	

<div class="content-footer">
	
	
	
	
	
	
</div>
	</article>

		</div>
	</div>
</div>
						
						<div class="break_floats"></div>
						
					</div>
				</div>
				
				
				
			</div>
			
			
		</div>
		
		<aside class="page-tools-sidebar js-page-tools-sidebar hide_for_print">
<div class="page-tools js-page-tools-menu">
<div class="page-tools__section page-tools__section--share">
<a class="page-tools__tool js-share-popup page-tools__tool--facebook" data-share-url="https://www.facebook.com/dialog/share?app_id=188669250943&amp;display=popup&amp;href=https%3a%2f%2fwww.cgialbanyny.com%2ftemplates%2farticlecco_cdo%2faid%2f6430169%2fjewish%2fRegister-for-Summer-2026.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dFB">
				<i class="fa fa-facebook"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--twitter" data-share-url="https://twitter.com/intent/tweet?text=Camp+Registration+-+Camp+Gan+Israel&amp;url=https%3a%2f%2fwww.cgialbanyny.com%2ftemplates%2farticlecco_cdo%2faid%2f6430169%2fjewish%2fRegister-for-Summer-2026.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dtwitter&amp;via=Chabad">
				<i class="fa fa-twitter"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--whatsapp d-lg-none js-share-whatsapp" data-share-url="whatsapp://send?text=Camp+Registration+-+Camp+Gan+Israel https%3a%2f%2fwww.cgialbanyny.com%2ftemplates%2farticlecco_cdo%2faid%2f6430169%2fjewish%2fRegister-for-Summer-2026.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dwhatsapp">
				<i class="fa fa-whatsapp">
					<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 50 50" fill="#128c7e" width="1em" height="1em"><path d="M25 2C12.318 2 2 12.318 2 25c0 3.96 1.023 7.854 2.963 11.29L2.037 46.73c-.096.343-.003.711.245.966.191.197.451.304.718.304.08 0 .161-.01.24-.029l10.896-2.699C17.463 47.058 21.21 48 25 48c12.682 0 23-10.318 23-23S37.682 2 25 2zm11.57 31.116c-.492 1.362-2.852 2.605-3.986 2.772-1.018.149-2.306.213-3.72-.231-.857-.27-1.957-.628-3.366-1.229-5.923-2.526-9.791-8.415-10.087-8.804-.295-.389-2.411-3.161-2.411-6.03s1.525-4.28 2.067-4.864c.542-.584 1.181-.73 1.575-.73s.787.005 1.132.021c.363.018.85-.137 1.329 1.001.492 1.168 1.673 4.037 1.819 4.33.148.292.246.633.05 1.022s-.294.632-.59.973-.62.76-.886 1.022c-.296.291-.603.606-.259 1.19s1.529 2.493 3.285 4.039c2.255 1.986 4.158 2.602 4.748 2.894.59.292.935.243 1.279-.146.344-.39 1.476-1.703 1.869-2.286s.787-.487 1.329-.292c.542.194 3.445 1.604 4.035 1.896.59.292.984.438 1.132.681.148.242.148 1.41-.344 2.771z"/></svg>
				</i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--pinterest d-none d-lg-block" data-share-url="http://pinterest.com/pin/create/button/?url=https%3a%2f%2fwww.cgialbanyny.com%2ftemplates%2farticlecco_cdo%2faid%2f6430169%2fjewish%2fRegister-for-Summer-2026.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dpinterest&amp;description=Camp+Registration+-+Camp+Gan+Israel">
				<i class="fa fa-pinterest"></i>
			</a>
<a class="page-tools__tool" onclick="showEmailLayer(this);">
<i class="fa fa-envelope"></i>
</a>
</div>
<div class="page-tools__section page-tools__section--other js-page-tool-other">
<div class="page-tools__tool popover-parent d-lg-block">
<div class="popover popover--right align_left nowrap">
<div class="popover__content">
<label class="bold bottom_margin block">
Print Options:
</label>
<form class="vcenter" name="print-form" onsubmit="coPrint(event, 6439348);return false;">
<div>
<label><input type="checkbox" name="print-green"><span title="Save paper and ink">Print without images <i class="fa fa-leaf text-green"></i></span></label>
</div>
<br/>
<div class="center">
<button class="co-button page-tools__print-button">Print</button>
</div>
</form>
</div>
</div>
<i class="fa fa-print"></i>
</div>
</div>
</div>
<div class="js-fab-wrapper fab-wrapper">
<div class="fab">
<i class="fab-icon"></i>
</div>
</div>
</aside>
<!-- END CACHE -->
	</div>

		</div>
			<div class="footer">
			<div class="wrapper">
				<div class="footer__extended">
					<div class="footer__information">
						<div>
							<i class="fas fa-home address-icon"></i>
							<div class="footer__address__container">
								<div class="footer__address">
									<h2>Camp Address</h2>
									<p>
										<span class="footer-street">404 Partridge Street </span>
										<br/><span class="footer-city-state">Albany, NY 12208</span>
										
										<br/><span>518-698-1836</span>
										
									</p>
								</div>
								
							</div>
						</div>
					</div>
					<div class="footer-menu-container">
						
            <ul class="nav-menu --expanded ">
    
        <li class="nav-menu__item nav-menu__item--has-children js-menu-item-has-child">
            <a href="/templates/articlecco_cdo/aid/6380655/jewish/About.htm">About</a>
			
        
                <ul class="nav-menu__submenu js-submenu">
            
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439332/jewish/About-Our-Camp.htm">About Our Camp</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439334/jewish/Our-Mission.htm">Our Mission</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292424/jewish/Why-We-CGI.htm">Why We ❤ CGI</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292429/jewish/Message-from-the-Director.htm">Message from the Director</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292431/jewish/Our-Facility.htm">Our Facility</a>
                        </li>
                    
                </ul>
            
    
        <li class="nav-menu__item nav-menu__item--has-children js-menu-item-has-child">
            <a href="/templates/articlecco_cdo/aid/6439339/jewish/Program.htm">Program</a>
			
        
                <ul class="nav-menu__submenu js-submenu">
            
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439340/jewish/Calendar-2026.htm">Calendar 2026</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/7292670/jewish/Activities.htm">Activities</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439341/jewish/Trips-Swimming-Transportation.htm">Trips, Swimming, & Transportation</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439343/jewish/Lunch.htm">Lunch</a>
                        </li>
                    
                        <li class="nav-menu__submenu-item">
                            <a href="/templates/articlecco_cdo/aid/6439344/jewish/Jewish-Theme.htm">Jewish Theme</a>
                        </li>
                    
                </ul>
            
    
        <li class="nav-menu__item ">
            <a href="/templates/photogallery_cdo/aid/6443504/jewish/Photos.htm">Photos</a>
			
        
    
            </ul>
    

					</div>
				</div>
				<div class="footer__main">
					<div class="footer__copyright">
                        



	<div class="footer3">
		<span class="footer-title" >Camp Gan Israel</span>
		<div class="footer-address">
			
			<span class="footer-city-state">Albany, NY 12208</span>
		</div>
			<span>518-698-1836</span>
	</div>
	<img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="6" border="0" /><br />



Powered by <a href="https://www.chabad.org/" target="_new" class="copyright-link">Chabad.org</a> &copy; 1993-2026 <a href="/4026210" target="_blank" class="privacy-link">Privacy Policy</a>




					</div>
					<div class="footer__social">
                        


<div class="cs-f-social-icons">
	
			<a href="https://www.facebook.com/CGIAlbany" class="fa fa-facebook facebook_homepage" title="Facebook"></a>
		
</div>
	

					</div>
				</div>
			</div>
		</div>
	</div>

	

	
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery-latest.min.js?v=278824AF"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery/jquery.inputmask.min.js?v=BF33D3B4"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/co/dist/CoLib.js?v=6777A16C"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/WebComponents/bundles/magen-cdo-global.js?v=A13136FE"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/camp/main.js?v=0E258064"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/modules/pagetools.js?v=930B07AB"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/multimedia/infolayer.js?v=ED1B8531"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/forms/userform.js?v=E69144BF"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/article/comments/reply-form-controller.js?v=F39697ED"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/commentsloader.js?v=AD6AAB79"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/subscribeprompt.js?v=86D84DC2"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/FormDecoder.js?v=83AF6F1A"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/deprecated.js?v=D506A83E"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/OverrideJSDocumentWrite.js?v=9A0227AA"></script><script>$j = $j.fn ? $j : jQuery;$j(()=>{$q.forEach(f=>{try{f.call(window);}catch(ex){console.error(ex);}});})</script>
	

<script  language="javascript" type="text/javascript"> Co.Settings      = {CacheClassName:'js-cache-default',MosadName:'Camp Gan Israel'}; Co.ArticleId     = '6430169';Co.SectionId     = 6439348;Co.PartnerSiteId = 0;Co.SiteId        = 12101;Co.IsMobilePage  = false;Co.IsResponsive  = false;Co.DbDomain      = 'CGIAlbanyNY.com';Co.LanguageCode  = '';Co.LoginStatus   = 'None';</script>
</body>
</html>