Junior Winter Camp 2017: Machane Moana
Machane Moana

HABONIM DROR AOTEAROA NEW ZEALAND - Junior Winter Camp 2017 APPLICATION FORM

Standard fees apply. Standard needs to be paid by 2nd July.

Fees: 1 child $220 2 children $396 3 children $528


DATE: SUNDAY 16TH JULY - WEDNESDAY 19TH JULY

We ask you take the time to complete this form in full to enable us to take the best care of your children. Please add any additional information. If you have any questions about this please contact Rosh Machane, Tom Kazula at juniorwintercamp@habo.co.nz or +6421 024 65256

First Name
Your answer
Last Name
Your answer
Date of Birth (DD/MM/YYYY)
Your answer
Chanich/a's email
Your answer
Chanich/a's cellphone
Your answer
Family email
Your answer
Family contact phone number
Your answer
Parent cellphone
Your answer
Street name and number
Your answer
Suburb
Your answer
City
Your answer
Alternative emergency contact name
Your answer
Alternative emergency contact number
Your answer
Habo group 2017 (Based on year level at school)
Tetanus and immunisations
Allergies
If none please write none
Your answer
Medication (must be brought to camp)
If none please write none
Your answer
Other - please specify e.g dietary requirements
If none please write none
Your answer
Other (social)
In order to ensure your child has the best possible experience please let us know if your child has any specific needs that we should keep in mind while caring for them. E.g. dyslexia, mild attention disorders, emotional sensitivity to specific situations.
Your answer
City travelling from (before camp)
Your answer
City travelling to (after camp)
Your answer
Payment-Standardfees
This camp cost covers transport, food and activities over the weekend. Please get in touch with our Gizbarit (Treasurer) Alison Bosman on gizbarut@habo.co.nz if you wish to arrange a payment plan to suit your family's needs.
Scholarship fund
The mission of Habonim Dror Aotearoa New Zealand (HDANZ) is to provide a Jewish educational experience to children. As such, it is our belief that financial obstacles should be eliminated in order for every child who is eligible to take part in this life changing program. Please donate to our scholarship fund if you are able, so that all Jewish children can enjoy the Habonim Dror experience.
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms