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Junior Gan Israel Day Camp
Pickup Information Form


Please complete this form for each child. If your child is using camp-provided transportation to go home, this form is not needed.

This information is for your child's safety. Please take the time to fill this out completely.

If there have been any changes in phone numbers (home, cell, work) since you filled out your child’s registration form, please give Zeesy Posner or your child’s Division Head the updated information.

If you would like to print this form and fill it in by hand, please give it to the Division Head in whose group your child(ren) end their day.

Click here to download the printable PDF version of this form.


 

Camper’s Name:

Departing time:

12:00 1:00 3:30

 

Leaving with:

   

Monday Driver:


Home Phone:
Cell Phone:

Tuesday Driver:


Home Phone:
Cell Phone:

Wednesday Driver:


Home Phone:
Cell Phone:

Thursday Driver:


Home Phone:
Cell Phone:

Friday Driver:


Home Phone:
Cell Phone:

Comments:

 

Parent Signature: