Camp BITNUA, October 3rd-6th 2018: Registration Form
Please be noticed that there are only few rooms left!
Filling up the online registration form does not assure your official participation.
You must have a confirmation number which will be given to you by Hila
Email address *
First Name *
Your answer
Last Name *
Your answer
Israeli No. / Phone No. (including state code) *
Your answer
I.D No.
Your answer
State *
Your answer
City *
Your answer
Registered by: *
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Tuesday, October 2nd: One day trip to Petra-Jordan with BITNUA team (7:00-19:00) *
370$ - Including: taxes, visa, transport & lunch / Excluding: accommodation & other meals. Will be paid separately.
Hotel Requested *
Number of people in the room *
SELECT YOUR PREFERABLE OPTION: *
(all prices referred to Wednesday-Saturday)
Required
Credit Card No. *
Those who prefer passing by private can contact: +972526966019 (Hila)
Your answer
Expiration Date (Month / Year) *
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CVV *
Your answer
Total amount of charge (For the camp only): *
Your answer
Children *
Required
If yes, Age of the children and shirt size (for children only)?
Your answer
Roommate's Full name: *
Your answer
Roommate's Phone No.: *
Your answer
Roommate's State and City *
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Roommate's Full name:
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Roommate's Phone No.:
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Roommate's State and City
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Roommate's Full name:
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Roommate's Phone No.:
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Roommate's State and City
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Special Requests / Notes
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I hereby approve the registration and charge for CAMP BITNUA 2018, Eilat, Israel *
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