Child's first name (שם הילד (נא לכתוב באנגלית *

Child's Last Name שם המשפחה של הילד *

Gender מין *

Child's Teudat Zehut or foreign Passport No. - מס' תעודת זהות או מספר דרכון של הילד

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 *

Camper's shirt size מידת חולצת-טי *

Child's Date of Birth - תאריך לידה *

Parent 1 הורה *

Parent 1's Phone מס' טלפון הורה 1 *

הורה 2 - Parent 2

Parent 2 phone - מספר טלפון להורה השני *

Parent's Email Address דואר אלקטרוני של ההורה *

Address כתובת *

Emergency Contact Name (other than parent)- שם איש קשר למצב חירום במקרה שההורים לא עונים *

Emergency Contact Phone - מס' טלפון לאיש קשר בחירום *

Family Doctor (name & phone) - רופא משפחה - שם ומס' טלפון

Kupat Cholim - (Insurance company) קופת חולים

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' *

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 *

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. *

Electronic Signature חתימה אלקטרונית

Is there anything else you'd like us to know? יש עוד משהו להגיד לנו? ו