Kedma Application
Application are not finalized until a $1000 deposit (fully refundable up to 6 weeks before departure) is submitted.
Personal Information
Campers First Name *
Campers Last Name *
Name of contact person *
Person filling out the application
Address *
City *
State *
Zip *
Home Phone *
Parents cell
Nationality *
Place of Birth *
Age *
age of this coming summer
Date of Birth *
Fathers Name *
Fathers Email
Fathers Occupation and Firm Name
Mothers Name *
Mothers Email
Mothers Occupation and Firm Name
Schools and Camps
Present School Attending *
Other Schools Previously Attended *
Current Grade Level *
General Class Work *
Excellent Very Good Good Fair Weak
Camps Previously Attended
skills and Hobbies *
List and describe briefly, skills, hobbies, interests, including music, sports etc...
Swimming level *
Camp requires the wearing of life jackets in all lakes and oceans, even for professional swimmers.
Friends, with whom you'd like to bunk (if same age)
Flight Arrangements
You have the option of flying with camp or on your own. Those flying with camp airline have the option of changing the inbound or outbound flight (not both) without a charge, if given enough notice.
Name on Passport
If you do not have a passport please apply for one immediately. New laws require that your passport does not expire within 6 months AFTER travel date.
Passport Number
Passport Exp.
References
List 2 references.
School teacher or principal.
Reference #1 Name and Relationship *
Reference #1 Phone *
Please include home and cell if possible
Reference #2 Name and Relationship *
Reference #2 Phone *
Please include home and cell if possible
Other Information
How did you find out about our camp? *
Permission for Off Day *
The program allows for one off day whereby campers are given the opportunity to visit relatives or friends in Israel. Campers who do not elect to use their off day are given a special program under full camp supervision. Parents giving their child permission to leave camp assume all responsibility.
Required
Medical Insurance *
Camp provides an addition insurance in case of emergencies
Special Medical Instructions
Are you requesting financial aid or scholarship?
please provide as much info as possible
Please upload a recent photo of the applicant
Signature of parent or guardian *
Any Additional comments please fill in here
Become a camp representative.
Camp offers 100 shekel spending money in Israel for signing up another camper.
Would you like us to send your friends some camp information?
Provide us with mailing addresses or email addresses below
Would you like us to mail you some camp flyers and brochures to hand out to you friends?
Submit
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