Camp Registration

This form is currently closed.

Summer at MLS offers children aged 18 months to 5 years a fun and engaging environment filled with activities like soccer, art, music, theater, science, and more. With plenty of outdoor play, water activities, and nutritious snacks, the program encourages curiosity and independence in a safe and supportive space. Experienced staff ensure a secure and nurturing environment where children can make friends, explore new interests, and have a blast.
Where did you hear about us?
1. Parents Information
Parental Marital Status*
I am the child's*

FatherMotherLegal Gaurdian
Full Name*
First Name Last Name
E-mail*
Phone Number*

Address*

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

Background*

Jewish by birthJewish by conversionNot Jewish
Parent's Name*
First Name Last Name
Parent's Phone Number*
Parent's E-mail*
Parent's Background*

Jewish by birthJewish by conversionNot Jewish
Other Parent's Name*
First Name Last Name
Other Parent's Phone Number*
Other Parent's E-mail*
Other Parent's Background*

Jewish by birthJewish by conversionNot Jewish
Dates for Camp
Dates for camp:
- Full Session June 5th- July 3rd
  - Week 1 June 5th-13th (7 days)
  - Week 2 June 16th-20th (5 days)
  - Week 3 June 23rd-27th (5 days)
  - Week 4 June 30th- July 3rd (3.5 days) (4 days for classes that end at 12)
Enrollment Period
Early Enrollment: Feb 2nd- Feb 28th noon

Regular Enrollment: Feb 28th 12:01pm - May 1st 6pm

Registration Closes Tentative May 25 (last call prices, based on availability)
2. Children’s Information
Number of children being registered
Child 1
Full Name*
First Name Last Name
Does your child currently attend My Little School?*

YesNo
Child 1 Current MLS class name*
Birth Date*

Month Day Year
Gender*
Is your child adopted?*

YesNo
*All prices shown are Early Bird Special Prices
Caregiver Track

Full Session $1365Week 1 June 5 - June 13th $420Week 2 June 16-20 $315Week 3 June 23-27 $315Week 4 June 30-July 3 $315
Track A

Full Session $3150Week 1 June 5 - June 13th $1050Week 2 June 16-20 $750Week 3 June 23-27 $750Week 4 June 30-July 3 $600
Track B

Full Session $4410Week 1 June 5 - June 13th $1470Week 2 June 16-20 $1050Week 3 June 23-27 $1050Week 4 June 30-July 3 $840
Track C

Full Session $4788Week 1 June 5 - June 13th $1596Week 2 June 16-20 $1140Week 3 June 23-27 $1140Week 4 June 30-July 3 $912
Is your child currently receiving any services or have an Individualized Education Program (IEP)?* If no write "N/A"
Medical Information Child 1:
Pediatrician*
First Name Last Name
Phone Number*

Area Code Phone Number
Insurance*
My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise*

YesNo
Are there any medical, developmental or emotional conditions we should be aware of? If none write "N/A"*
Is your child allergic to anything eg: Medications, foods, etc.? If yes, please explain*
Does your child have an EpiPen?* If "Yes" Please email us at [email protected] to book a meeting to discuss your child’s allergy plan.

YesNo
Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain*
Language(s) spoken at home?*
You will make us aware of any updates to your child's medical information*

Yes, I take full responsibility to update you with the most accurate medical information regarding my child
Child 2
Full Name*
First Name Last Name
Does your child currently attend My Little School?*

YesNo
2nd Child Current MLS class name*
Birth Date*

Month Day Year
Gender*
Is your child adopted?*

YesNo
Caregiver Track

Full Session $1365Week 1 June 5 - June 13th $420Week 2 June 16-20 $315Week 3 June 23-27 $315Week 4 June 30-July 3 $315
Track A

Full Session $3150Week 1 June 5 - June 13th $1050Week 2 June 16-20 $750Week 3 June 23-27 $750Week 4 June 30-July 3 $600
Track B

Full Session $4410Week 1 June 5 - June 13th $1470Week 2 June 16-20 $1050Week 3 June 23-27 $1050Week 4 June 30-July 3 $840
Track C

Full Session $4788Week 1 June 5 - June 13th $1596Week 2 June 16-20 $1140Week 3 June 23-27 $1140Week 4 June 30-July 3 $912
Is your child currently receiving any services or have an Individualized Education Program (IEP)?* If no write "N/A"
Medical Information Child 2:
Pediatrician*
First Name Last Name
Phone Number*

Area Code Phone Number
Insurance*
My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise*

YesNo
Are there any medical, developmental or emotional conditions we should be aware of? If none write "N/A"*
Is your child allergic to anything eg: Medications, foods, etc.? If yes, please explain*
Does your child have an EpiPen?* If "Yes" Please email us at [email protected] to book a meeting to discuss your child’s allergy plan.

YesNo
Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain*
Language(s) spoken at home?*
You will make us aware of any updates to your child's medical information*

Yes, I take full responsibility to update you with the most accurate medical information regarding my child
Child 3
Full Name*
First Name Last Name
Does your child currently attend My Little School?*

YesNo
3rd Child Current MLS class name*
Birth Date*

Month Day Year
Gender*
Is your child adopted?*

YesNo
Caregiver Track

Full Session $1365Week 1 June 5 - June 13th $420Week 2 June 16-20 $315Week 3 June 23-27 $315Week 4 June 30-July 3 $315
Track A

Full Session $3150Week 1 June 5 - June 13th $1050Week 2 June 16-20 $750Week 3 June 23-27 $750Week 4 June 30-July 3 $600
Track B

Full Session $4410Week 1 June 5 - June 13th $1470Week 2 June 16-20 $1050Week 3 June 23-27 $1050Week 4 June 30-July 3 $840
Track C

Full Session $4788Week 1 June 5 - June 13th $1596Week 2 June 16-20 $1140Week 3 June 23-27 $1140Week 4 June 30-July 3 $912
Is your child currently receiving any services or have an Individualized Education Program (IEP)?* If no write "N/A"
Medical Information Child 3:
Pediatrician*
First Name Last Name
Phone Number*

Area Code Phone Number
Insurance*
My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise*

YesNo
Are there any medical, developmental or emotional conditions we should be aware of? If none write "N/A"*
Is your child allergic to anything eg: Medications, foods, etc.? If yes, please explain*
Does your child have an EpiPen?* If "Yes" Please email us at [email protected] to book a meeting to discuss your child’s allergy plan.

YesNo
Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain*
Language(s) spoken at home?*
You will make us aware of any updates to your child's medical information*

Yes, I take full responsibility to update you with the most accurate medical information regarding my child
Child 4
Full Name*
First Name Last Name
Does your child currently attend My Little School?*

YesNo
Current MLS class name*
Birth Date*

Month Day Year
Gender*
Is your child adopted?*

YesNo
Caregiver Track

Full Session $1365Week 1 June 5 - June 13th $4Week 2 June 16-20 $315Week 3 June 23-27 $315Week 4 June 30-July 3 $315
Track A

Full Session $3150Week 1 June 5 - June 13th $1050Week 2 June 16-20 $750Week 3 June 23-27 $750Week 4 June 30-July 3 $600
Track B

Full Session $4410Week 1 June 5 - June 13th $1470Week 2 June 16-20 $1050Week 3 June 23-27 $1050Week 4 June 30-July 3 $840
Track C

Full Session $4788Week 1 June 5 - June 13th $1596Week 2 June 16-20 $1140Week 3 June 23-27 $1140Week 4 June 30-July 3 $912
Is your child currently receiving any services or have an Individualized Education Program (IEP)?* If no write "N/A"
Medical Information Child 4:
Pediatrician*
First Name Last Name
Phone Number*

Area Code Phone Number
Insurance*
My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise*

YesNo
Are there any medical, developmental or emotional conditions we should be aware of? If none write "N/A"*
Is your child allergic to anything eg: Medications, foods, etc.? If yes, please explain*
Does your child have an EpiPen?* If "Yes" Please email us at [email protected] to book a meeting to discuss your child’s allergy plan.

YesNo
Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain*
Language(s) spoken at home?*
You will make us aware of any updates to your child's medical information*

Yes, I take full responsibility to update you with the most accurate medical information regarding my child
If you have additional children, please contact us.
Planning for next semester?
Will you be sending one or more of your children to My Little School for the first time Fall of this year?
1st Child Full Name
First Name Last Name
Birth Date

Month Day Year
2nd Child Full Name
First Name Last Name
Birth Date

Month Day Year
3rd Child Full Name
First Name Last Name
Birth Date

Month Day Year
3. Child Pick-Up
List everyone who your child(ren) may be picked up from camp by: Full Name, Contact number, relation to child
Name / Number / Relationship
3. Emergency Information
Emergency Contact
First Name Last Name
Phone Number

Area Code Phone Number
Relationship
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.
Signature of Parent or Guardian*
Date & Time*

Month Day Year
at Hour Minutes
4. Payment Information
A $700 non-refundable registration fee per child applies as part of this registration.
Total

$0.00

I would like to pay today:Full amount$700.00 minimum$

Payment*

Credit Card Paypal Send Me An Invoice

Postal / Zip Code

Country

General comments
5. Terms and Conditions
- By signing my name in the box below, I agree to the following terms: I hereby permit my child(ren) to participate in all activities at Chabad of Tribeca/My Little School 2024, on-site, off-site and on any trips. I release Chabad of Tribeca/My Little School and all individuals from any liability arising out of any injury to my child(ren). I understand that my child(ren) may be dismissed during a camp day, due to illness, at the discretion of the camp, and I agree to abide by the director’s decision. In the event of a medical or surgical emergency, I grant permission to the physician designated by Chabad of Tribeca/My Little School to hospitalize, secure proper treatment for and order injections, anesthesia or surgery for my child(ren). Furthermore, I understand that payment for medical services is solely the family’s responsibility.
- PARENTAL CONSENT: I hereby give consent for my child to participate in all activities of My Little School (MLS) both on and off site, trips, transportation to and from trips etc., unless I advise you otherwise in writing.
- PAYMENT AND CANCELATION: By signing my name in the box below, I agree to pay the full tuition for the period indicated on this enrollment form. I acknowledge that no tuition refunds for early bird registrations will be processed after 03/14/2024. All early bird registrations are deemed final as of 03/15/2024.. Additionally, I acknowledge that no tuition refunds for full price tuition will be accommodated after 04/14/2024, and all full price tuition registrations are finalized as of 04/15/2024.
- DISMISSAL OF CAMPER: Parent fully understands and agrees that the Camp reserves the right to dismiss, in its sole discretion, any Camper whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interests of the Camp or fellow campers or who violates camp rules and regulations.
- IMAGES, ETC.: Permission is hereby given to use in promoting the Camp and in other ventures directly relating to the Camp (i) digital, photographic and video images or likenesses of camper; audio of camper; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by camper or originating from Camp or from a Camp-related activity.
- INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless My Little School (MLS) and its officers, servants or assignees from any liability concerning our child’s involvement in MLS and further agree that the use of any premises during the MLS camp day is made at the risk of the registrant.
- I have read and agree to all of the terms and conditions in this Application Form.
Agreement*

I am signing up my child for camp. I give my child permission to attend all trips and receive medical care in the case of emergency, G-d forbid. I give Gan Israel permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the camp sees fit.
Official E-Signature of Parent or Guardian*
Date & Time*

Month Day Year
at Hour Minutes
Should be Empty:

This page uses TLS encryption to keep your data secure.

1. Parents Information

Dates for Camp

Enrollment Period

2. Children’s Information

Child 1

Medical Information Child 1:

Child 2

Medical Information Child 2:

Child 3

Medical Information Child 3:

Child 4

Medical Information Child 4:

Planning for next semester?

3. Child Pick-Up

3. Emergency Information

4. Payment Information

5. Terms and Conditions