Summer 2019 Kaytannot @The Open Studio
Please submit a separate form for each child. For all camp information, please see www.openstudiojlem.com. For questions, please call 054-626-8496 or email openstudiojlem@gmail.com.

Cancellation Policy:
For cancellation more than 2 full weeks before the start of the session, there is a fee of 400 NIS.
Cancellations 2 full weeks or less before the start of the session will not be refunded.

LOCATION UPDATE: Camp will be taking place Kehillat Mivahshe Derech, Shai Agnon 22 in the San Simone neighborhood of Jerusalem. Bus lines: 15 & 22. Nitzanim camps will be here unless otherwise noted below.

יש למלא טופס נפרד לכל ילד.
לשאלות נא להתקשר 054-626-8496 או לשלוח מייל לדוא"ל openstudiojlem@gmail.com l
לביטול יותר משבועיים לפני המחזור יש תשלום של 400 ש"ח. לביטול שבועיים או פחות לפני המחזור אין החזרים.
Child's first name (שם הילד (נא לכתוב באנגלית *
Your answer
Child's Last Name שם המשפחה של הילד *
Your answer
Gender מין *
Child's Teudat Zehut or foreign Passport No. - מס' תעודת זהות או מספר דרכון של הילד
Your answer
Personal Details פרטים אישיים
Choose Session(s) נא לבחור מחזורים
Please put my child in a group with the following campers (up to 2) נא להחביר את הילד שלי לקבוצה עם הילדים הבאים, עד 2 ילדים *
Your answer
Camper's shirt size מידת חולצת-טי *
Child's Date of Birth - תאריך לידה *
MM
/
DD
/
YYYY
Parent 1 הורה *
Your answer
Parent 1's Phone מס' טלפון הורה 1 *
Your answer
הורה 2 - Parent 2
Your answer
Parent 2 phone - מספר טלפון להורה השני *
Your answer
Parent's Email Address דואר אלקטרוני של ההורה *
Your answer
Address כתובת *
Your answer
Emergency Contact Name (other than parent)- שם איש קשר למצב חירום במקרה שההורים לא עונים *
Your answer
Emergency Contact Phone - מס' טלפון לאיש קשר בחירום *
Your answer
Family Doctor (name & phone) - רופא משפחה - שם ומס' טלפון
Your answer
Kupat Cholim - (Insurance company) קופת חולים
Your answer
Do you need early drop off (from 8:30)? האם הילד צריך להגיע מוקדם , 80₪ per week? *
Do you need Tzaharon (Afternoon Program) 14:00-16:00, 150nis/week? ?האם תצטרכו צהרון לילד *
Any known medical conditions, allergies, etc. - אלרגיות או בעיות בריאות - כמו סכרת וכד' *
Your answer
Language - שפה *
Payment - תשלום . One your registration is received, we will send you an invoice via Email. International payments can be made by credit: Mastercard or American Express but incur an additional 5% charge. We will email you a link. Please note: the Early Bird Discount applies only if payment is made by June 16 (100 nis discount) הנחת הרשמה מוקדמת תינתן רק לתשלומים המתבצעים לפני 16.6.19 *
Discounts הנחות *
Required
Camp Regulations תקנון הקייטנה
1. Campers are responsible for bringing lunch. Each morning, a different group will be preparing a healthy snack for the camp with the guidance of our educational chef. 2. Non-Kosher food may not be brought into the camp grounds. 3. We are making an effort this summer to avoid using single-use plastics in camp. We will email you more details about this before camp begins. Campers are expected to bring reusable water bottles and their lunches in backpacks & lunchboxes rather than plastic bags. Plastic utensils will not be provided. 4. Camp is authorized to use digital photography or video of your child on our website and for advertising purposes. If you do not allow this, please make it clear in your registration. 5. I hereby give permission for my child to leave Camp grounds for Camp programs.6. I hereby give permission for my child to participate in any and all camp activities. I fully understand that some of the activities may include certain risks.7. All campers are obligated to behave properly and with respect. 8. Campers clothing might get dirty and stained. 9. Private cell phones, tablets and other devices are not permitted to be used during the camp day. 10. Do not bring any cash or other valuables to camp. 11. Due to the recent measles outbreak, only vaccinated children will be permitted in camp. *
Your answer
Parent Signature
Electronic Signature חתימה אלקטרונית
Please type name and Teudat Zehut or Foreign Passport No. נא למלות שם ומס' תעודת זהות
Your answer
Is there anything else you'd like us to know? יש עוד משהו להגיד לנו? ו
Your answer
A little bit about us... קצת על עצמנו
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