Summer Camp 2023

unique_id

Parent 1 information

Full name

relation to camper

cell phone

country

city

street name and number

Single parent?

No Yes

Parent 2 Information

Full name

relation to camper

cell phone

country

city

street name and number

Emergency contact information:

Full name

relation to camper

cell phone

full address

Camper information

full name

profile pictrue

session dates

date of birth

gender

male female

graduating which grade

7th 8th 9th

School

My Affiliation

does camper live in Israel?

Yes No

languages spoken:

health insurance:

ID/passport number

shirt size

camper email

camper cell phone number

Friend requests

You may state the names of up to two friends you would like to be roomed with. If both campers choose one another, we will do our best to assign them together. It is important to note that it is possible that for various reasons we will not be able to grant these requests, but we will do our best.

friend name number 1

friend name number 2

social media profiles

if you would like to share your social media - NOT MANDATORY - you can copy and paste link to campers profile in the designated box

facebook

instagram

tik tok

medical information and permission

Dietary preferences

asthma

Yes No

epilepsy

Yes No

allergies

Yes No

Details:

diabetes

Yes No

any other medical condition

Yes No

Details:

medication taken regularly

Yes No

Details:

my child has the following restrictions:

decleration of health

I declare that I am unaware of any additional medical restrictions that would prevent my child from fully participating in the general activities of the camp including day trips and hikes, swimming and bicycle riding.

I have read and accept the camp regulations

I allow Masa Israeli to contact me using different platforms, including email, text messages and WhatsApp. This includes marketing content.

I am aware that the camp activities will be photographed and documented, and give my consent to Masa Israeli to make use of photos in which my child appears for marketing purposes.

I came through:

Friend Full name

Friend Cell phone

Other

after clicking the button, you will complete the registration and will be transferred to an additional page for payment. It is important to note that your spot in camp is not finalized until payment. After completing payment, you will receive a message confirming the registration. Please note that after the payment page, there is an option to add a donation to help us subsidize payment for a camper from a low-income background. Any sum would be appreciated and will help us give another child an opportunity for an unforgettable experience.

Summer Camp 2023!