Yesh Winter Camp 2018 Application Form

VERY IMPORTANT – PLEASE NOTE:
. The information required in this form is of critical importance to the organizers and persons running Yesh for both the camps & activities throughout the year. All the information herein contained is for your child’s own benefit & should be completed meticulously & with care.
. The failure to supply all relevant and accurate information could have serious consequences for your child and other members of Yesh Camp SA.
. This application form applies to the camps and all activities run by Yesh Camp SA throughout the year, of whatsoever nature or kind.
. Incomplete forms or forms altered in any manner or way are unacceptable and will be rejected, preventing the organizers from accepting your child to the camps or any activities.
All information herein contained will be kept confidential.
Particular's of Camper
Please enter camper NAME AND SURNAME *
Your answer
Please enter camper HOME NUMBER *
Your answer
Please enter camper CELL NUMBER
Your answer
Please enter EMAIL ADDRESS at which we can contact camper *
Your answer
Please enter camper DATE OF BIRTH *
MM
/
DD
/
YYYY
Please enter camper HOME ADDRESS *
Your answer
Please enter camper SCHOOL, if not in school fill in N/A *
Your answer
Please enter camper GRADE *
PARTICULARS OF CAMPER’S PARENTS
FATHER'S NAME *
Your answer
FATHER'S CELL *
Your answer
MOTHER'S NAME *
Your answer
MOTHER'S CELL *
Your answer
In Case of Emergency 3rd Party Contact Name *
Your answer
In Case of Emergency 3rd Party Contact Relationship *
Your answer
In Case of Emergency 3rd Party Contact CELL *
Your answer
In Case of Emergency 3rd Party Contact HOME *
Your answer
Where did you hear about Yesh Camp SA *
Your answer
REFERENCES
Who is your community Rabbi? Please provide his cell number. *
Your answer
Who is the principal of your school? Please provide his cell number.
Your answer
Do you have a personal mentor? If yes please provide name and cell number. *
Your answer
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