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31","21_special":"None","21_allowOther":"No","21_otherText":"Other","21_calculateOther":"No","21_spreadCols":"1","21_selected":"","21_minSelection":"","21_maxSelection":"","21_description":"","21_name":"input21","21_qid":21,"21_type":"control_checkbox","21_order":16,"21_pricing":"400|400|400|400","26_text":"I would like to enroll my second child for the following weeks HALF DAY 9am - 12:30pm","26_message":"","26_labelAlign":"Auto","26_required":"No","26_options":"Week 1: July 6-10|Week 2: July 13-17|Week 3: July 20-24|Week 4: July 27-July 31","26_special":"None","26_allowOther":"No","26_otherText":"Other","26_calculateOther":"No","26_spreadCols":"1","26_selected":"","26_minSelection":"","26_maxSelection":"","26_description":"","26_name":"input26","26_qid":26,"26_type":"control_checkbox","26_order":17,"26_pricing":"360|360|360|360","19_labelAlign":"Auto","19_text":"Tuition 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<form class="userform-form" action="" method="post" name="form_5865794" id="5865794" accept-charset="utf-8"><input type="hidden" name="formID" value="5865794" /><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 style="text-align: center;">2026 Camp Gan Israel</p>

<p style="text-align: center;">Summer Program - Registration Form Request</p>

<p style="text-align: center;"><strong>Space is limited and will be filled on a first come first serve basis, with priority given to current students and alumni.<br />
<u>An email will be sent to confirm your spot.</u></strong></p>

<p style="text-align: center;"><strong>PRESCHOOL DIVISION: AGES 2 -5 </strong><br />
<em>Children must have prior school experience</em><br />
<br />
<strong>ELEMENTARY AGE DIVISION: KDG &amp; 1ST GRADE GRADUATES</strong></p>

<p style="text-align: center;"><a href="https://drive.google.com/file/d/1WxN2PkJ4cknWMXHe-9p3rie-ILi6ur1R/view">Click Here to for PDF Registration Form </a></p>
</div> </div></li><li class="form-line" id="id_5"><div class="form-label-left" id="label_5"><label for="input_5"> Mother's Name<span class="form-required">*</span> </label><label class="label-message" for="input_5"> </label></div><div id="cid_5" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q5_fullName5[first]" id="first_5" autocomplete="given-name" />  <label class="form-sub-label" for="first_5" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q5_fullName5[last]" id="last_5" autocomplete="family-name" />  <label class="form-sub-label" for="last_5" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_6"><div class="form-label-left" id="label_6"><label for="input_6"> Mother's Cell<span class="form-required">*</span> </label><label class="label-message" for="input_6"> </label></div><div id="cid_6" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q6_phoneNumber[area]" id="input_6_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_6_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q6_phoneNumber[phone]" id="input_6_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_6_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_7"><div class="form-label-left" id="label_7"><label for="input_7"> Mother's Email<span class="form-required">*</span> </label><label class="label-message" for="input_7"> </label></div><div id="cid_7" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_7" name="q7_email" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_8"><div class="form-label-left" id="label_8"><label for="input_8"> Father's Name<span class="form-required">*</span> </label><label class="label-message" for="input_8"> </label></div><div id="cid_8" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q8_fullName8[first]" id="first_8" autocomplete="given-name" />  <label class="form-sub-label" for="first_8" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q8_fullName8[last]" id="last_8" autocomplete="family-name" />  <label class="form-sub-label" for="last_8" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_9"><div class="form-label-left" id="label_9"><label for="input_9"> Father's Cell<span class="form-required">*</span> </label><label class="label-message" for="input_9"> </label></div><div id="cid_9" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q9_phoneNumber9[area]" id="input_9_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_9_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q9_phoneNumber9[phone]" id="input_9_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_9_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_10"><div class="form-label-left" id="label_10"><label for="input_10"> Father's E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_10"> </label></div><div id="cid_10" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_10" name="q10_email10" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_22"><div class="form-label-left" id="label_22"><label for="input_22"> I would like to register<span class="form-required">*</span> </label><label class="label-message" for="input_22"> </label></div><div id="cid_22" class="form-input"> <select class="form-dropdown validate[required]" style="width:150px" id="input_22" name="q22_input22"><option value=""></option><option value="1 Child">1 Child</option><option value="2 Children">2 Children</option></select> </div></li><li class="form-line" id="id_3"><div class="form-label-left" id="label_3"><label for="input_3"> Child's 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_23"><div class="form-label-left" id="label_23"><label for="input_23"> Child's Name 2 </label><label class="label-message" for="input_23"> </label></div><div id="cid_23" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q23_fullName23[first]" id="first_23" autocomplete="given-name" />  <label class="form-sub-label" for="first_23" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="15" name="q23_fullName23[last]" id="last_23" autocomplete="family-name" />  <label class="form-sub-label" for="last_23" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_4"><div class="form-label-left" id="label_4"><label for="input_4"> Date of Birth<span class="form-required">*</span> </label><label class="label-message" for="input_4"> </label></div><div id="cid_4" 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_4" name="q4_input4[month]" type="tel" size="2" maxlength="2" value="" />  <label class="form-sub-label" for="month_4" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="noDefault form-textbox validate[required]" id="day_4" name="q4_input4[day]" type="tel" size="2" maxlength="2" value="" />  <label class="form-sub-label" for="day_4" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox validate[required]" id="year_4" name="q4_input4[year]" type="tel" size="4" maxlength="4" value="" />  <label class="form-sub-label" for="year_4" id="sublabel_year">Year</label></span><span class="form-sub-label-container"><img class="showAutoCalendar" alt="Pick a Date" id="input_4_pick" src="https://w2.chabad.org/images/sitecontrol/formbuilder/calendar.png" align="absmiddle" />  <label class="form-sub-label" for="input_4_pick"><span> </span></label></span></div></div> </div></li><li class="form-line" id="id_24"><div class="form-label-left" id="label_24"><label for="input_24"> Date of Birth 2 </label><label class="label-message" for="input_24"> </label></div><div id="cid_24" 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_24" name="q24_input24[month]" type="tel" size="2" maxlength="2" value="" />  <label class="form-sub-label" for="month_24" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="noDefault form-textbox" id="day_24" name="q24_input24[day]" type="tel" size="2" maxlength="2" value="" />  <label class="form-sub-label" for="day_24" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><input autocomplete="nope" class="form-textbox" id="year_24" name="q24_input24[year]" type="tel" size="4" maxlength="4" value="" />  <label class="form-sub-label" for="year_24" id="sublabel_year">Year</label></span><span class="form-sub-label-container"><img class="showAutoCalendar" alt="Pick a Date" id="input_24_pick" src="https://w2.chabad.org/images/sitecontrol/formbuilder/calendar.png" align="absmiddle" />  <label class="form-sub-label" for="input_24_pick"><span> </span></label></span></div></div> </div></li><li class="form-line" id="id_11"><div id="cid_11" class="form-input-wide"> <div id="text_11" class="form-html"><p style="text-align: center;">WEEKLY TUITION:</p>

<p style="text-align: center;">MONDAY - FRIDAY:  HALF DAY (PRESCHOOL AGE ONLY) - 9:00am - 12:30pm - $400</p>

<p style="text-align: center;">MONDAY - FRIDAY:  FULL DAY (PRESCHOOL + ELEMENTARY AGE) - 9:00am - 3:00pm - $625</p>
</div> </div></li><li class="form-line" id="id_14"><div class="form-label-left" id="label_14"><label for="input_14"> I would like to enroll my child for the following weeks FULL DAY 9am - 3pm </label><label class="label-message" for="input_14"> </label></div><div id="cid_14" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_14_0" name="q14_input14[]" value="Week 1: July 6-10" /><label id="label_input_14_0" for="input_14_0"><span>Week 1: July 6-10</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_14_1" name="q14_input14[]" value="Week 2: July 13-17" /><label id="label_input_14_1" for="input_14_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" id="input_14_2" name="q14_input14[]" value="Week 3: July 20-24" /><label id="label_input_14_2" for="input_14_2"><span>Week 3: July 20-24</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_14_3" name="q14_input14[]" value="Week 4: July 27-July 31" /><label id="label_input_14_3" for="input_14_3"><span>Week 4: July 27-July 31</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_25"><div class="form-label-left" id="label_25"><label for="input_25"> I would like to enroll my second child for the following weeks FULL DAY 9am - 3pm </label><label class="label-message" for="input_25"> </label></div><div id="cid_25" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_25_0" name="q25_input25[]" value="Week 1: July 6-10" /><label id="label_input_25_0" for="input_25_0"><span>Week 1: July 6-10</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_25_1" name="q25_input25[]" value="Week 2: July 13-17" /><label id="label_input_25_1" for="input_25_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" id="input_25_2" name="q25_input25[]" value="Week 3: July 20-24" /><label id="label_input_25_2" for="input_25_2"><span>Week 3: July 20-24</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_25_3" name="q25_input25[]" value="Week 4: July 27-July 31" /><label id="label_input_25_3" for="input_25_3"><span>Week 4: July 27-July 31</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_21"><div class="form-label-left" id="label_21"><label for="input_21"> I would like to enroll my child for the following weeks HALF DAY 9am - 12:30pm </label><label class="label-message" for="input_21"> </label></div><div id="cid_21" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_21_0" name="q21_input21[]" value="Week 1: July 6-10" /><label id="label_input_21_0" for="input_21_0"><span>Week 1: July 6-10</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_21_1" name="q21_input21[]" value="Week 2: July 13-17" /><label id="label_input_21_1" for="input_21_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" id="input_21_2" name="q21_input21[]" value="Week 3: July 20-24" /><label id="label_input_21_2" for="input_21_2"><span>Week 3: July 20-24</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_21_3" name="q21_input21[]" value="Week 4: July 27-July 31" /><label id="label_input_21_3" for="input_21_3"><span>Week 4: July 27-July 31</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_26"><div class="form-label-left" id="label_26"><label for="input_26"> I would like to enroll my second child for the following weeks HALF DAY 9am - 12:30pm </label><label class="label-message" for="input_26"> </label></div><div id="cid_26" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_26_0" name="q26_input26[]" value="Week 1: July 6-10" /><label id="label_input_26_0" for="input_26_0"><span>Week 1: July 6-10</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_26_1" name="q26_input26[]" value="Week 2: July 13-17" /><label id="label_input_26_1" for="input_26_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" id="input_26_2" name="q26_input26[]" value="Week 3: July 20-24" /><label id="label_input_26_2" for="input_26_2"><span>Week 3: July 20-24</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_26_3" name="q26_input26[]" value="Week 4: July 27-July 31" /><label id="label_input_26_3" for="input_26_3"><span>Week 4: July 27-July 31</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_19"><div class="form-label-left" id="label_19"><label for="input_19"> Tuition Total </label></div><div id="cid_19" class="form-input"> <div id="total_amount">$0.00 </div> </div></li><li class="form-line" id="id_20"><div id="cid_20" class="form-input-wide"> <div id="text_20" class="form-html"><p style="text-align: center;">Tuition is due in full by May 1, 2026. 10% discount applied to sibling.</p>

<p style="text-align: center;">Space is limited and will be filled on a first come first serve basis with priority given to returning students.</p>

<p style="text-align: center;">Tuition is payable by cash, check to Chabad of North Brooklyn, venmo or credit card.</p>

<p style="text-align: center;">Contact the office to pay by venmo or credit card.</p>

<p style="text-align: center;">Students who are new to Gan Chabad Preschool must complete required DOH paperwork prior to attending.</p>
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