Gan 2026-27 Registration

Your child’s spot is secured once you have submitted all of the following:

1) Online Registration Form - EARLY-BIRD REGISTRATION is $300/Child ($500/Family), when submitted and paid by May 3, 2026. Registration fee AFTER that date is $400/child. ($700 maximum/family)
Pay online, check or Zelle: [email protected]
2) Signed Tuition Contract (will be emailed to you privately)
3) Tuition Head-Checks made out for the 1st or 15th of all 10 months of the school year (August - May) OR monthly charge set up.
4) Online Parent Handbook Read and Signed
5) Immunization Records (if we don't already have on file)

Tuition Schedule:

Name of Person Filling our the registration*

First Name Last Name

E-mail*

Registration Confirmation*

I understand that my child's registration is complete only after I submit all of the above listed items.

Number of Children to register

Child #1*

First Name Middle Name Last Name

Registration Fee - $300

Birth Date*

Month Day Year

Hebrew Name

Hebrew Birthdate

If you don't know hebrew birthday, please state city and time of birth (we can calculate it for you.)

What schedule are you looking to register this child for:*

Core (Mon- Fri 9:00 am- 2:00 pm) AND Extended Care (Mon- Thur 2:00- 3:45 pm)Core AND Extended- on selected days of the weekCore Day All Week (Mon- Fri 9:00 am- 2:00 pm)Core Day, selected days of the week

I allow my child's photographs to be used on the weekly blog, social media and Gan Camarillo Preschool marketing materials*

YesNo

Child #2*

First Name Middle Name Last Name

Registration Fee - second child - $200

Birth Date #2*

Month Day Year

Hebrew Name #2

Hebrew Birthdate #2

If you don't know hebrew birthday, please state city and time of birth (we can calculate it for you.)

What schedule are you looking to register this child for:*

Core (Mon- Fri 9:00 am- 2:00 pm) AND Extended Care (Mon- Thur 2:00- 3:45 pm)Core AND Extended- on selected days of the weekCore Day All Week (Mon- Fri 9:00 am- 2:00 pm)Core Day, selected days of the week

I allow my child's photographs to be used on the weekly blog, social media and Gan Camarillo Preschool marketing materials

YesNo

Please list all of your child’s allergies or dietary restrictions (Write "None" if there are none):*

Does your child take any medication on a regular basis? If yes, give name and purpose of medication(s).*

Will your child be taking the medication during school time?*

YesNo

During the past 12 months, has your child seen a professional to address mental/emotional health concerns?*

YesNo

Has your child ever received services from Tri-Counties Regional Center?*

YesNo

Please list any medical conditions that may interfere with your child’s learning:*

Describe any personal situations that may affect student’s ability to attend Gan or arrive on time on a regular basis:*

Mailing Address*

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

Name of Primary Parent/Guardian*

First Name Last Name

Occupation*

E-mail*

I would like to receive news and updates by email

Home Phone*

Cell Phone*

Work Phone

Text Messaging Opt-in

Add this Cell Phone to Gan Camarillo Whatsapp BroadcastYou may text message me at this number

Name of Second Parent/Guardian*

First Name Last Name

Occupation

Home Address* (if same as mailing address write “same”)

E-mail*

Home Phone*

Cell Number*

Text Messaging Opt-in

Add this Cell Phone to Gan Camarillo Whatsapp BroadcastYou may text message me at this number

Is the natural mother of the student Jewish?*

YesNo

Have there been any conversions or adoptions in the family?*

Emergency Contact #1*

Relation to child*

Phone Number* Cell Preferably

Emergency Contact #2*

Relation to child*

Phone Number* Cell Preferably

Family Physician*

Physician Phone Number*

Is your child/ren up to date on his/her/their immunizations*

YesNo

Please attach immunization records for each child.

I hereby voluntarily release from liability and waive any and all claims or causes of action for personal injury or death occurring to the student or others, or property damage arising from or relating to participation in the above activities, and whether arising from the negligence of Gan Camarillo Preschool or otherwise, against Gan Camarillo Preschool or any of its officers, agents, directors, teachers, or employees. I hereby release Gan Camarillo Preschool from liability for myself and my heirs, executors, administrators and assigns, and I shall indemnify and hold harmless Gan Camarillo Preschool from any and all such claims or causes of action, including attorney’s fees or damage to personal property. My signature on this form shall constitute an informed and knowing consent and waiver as required by law. I hereby acknowledge that I understand the effect of releasing Gan Camarillo Preschool of all such liability, including that caused by negligence.In case of an emergency, I give permission for my child to receive medical treatment.

I, the undersigned parent or guardian do hereby consent to any x-ray examination, anesthetic, medical or surgical diagnosis, or treatment and hospital service that may be rendered to said minor under the general or special treatment, and, hospital service that may be rendered to said minor under the general or special instructions, of our physician or other physician called in any emergency by the Gan Camarillo Director, the Rabbi, or responsible adult, in the event I/we cannot be reached, whether such diagnosis or treatment is rendered at the office of said physician or at a licensed hospital. It is understood that conscientious effort will be made to notify me or my spouse before such action is taken, but if this is not possible, the expense of this service will be accepted by me/us. It is understood that this consent is given in advance of any specific diagnosis or treatment being required. This consent shall remain effective until revoked. (By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.)

I give permission for my child/ren to be photographed and their photos to be placed in our advertisements, brochures, and websites. This includes but is not limited to: Chabadcamarillo.com, Gancamarillo.blogspot.com, the Gan Camarillo Facebook page and other social media platforms.

Field Trip Permission*

Yes, I give permission to participate in field trips (for Pre K/K Class), sponsored by Gan Camarillo Preschool. Transportation on field trips may be by school bus, parent drivers, or walking to nearby locations.

In case of such an emergency, please contact (name of parent or guardian):*

(By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge, and that you agree to the terms and conditions stated above unless otherwise noted.)

Electronic Signature*

Date*

Month Day Year

Total

$0.00

I would like to pay today:Full amount50% minimum: $0.00 $

Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

⚠ You have not yet connected a credit card processor.

Credit Card Check or Zelle

Postal / Zip Code

Country

Register Your Child/ren

Health Information

Family Information

Family History

Emergency Contacts

Medical Information

Waiver of Liability

Payment Information

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