Bnei Mitzvah - Bnei Akiva UK

Bnei Mitzvah Programme

Step 1 of 2

Name (Primary Contact)*
First Last
Email*
Primary Contact Phone (Mob.)*

Children's Details
Which Sviva do you attend?*
This will be the Sviva you are signed up to take the programme at.
How many children are you booking for?
Child 1
Child 1 Name
Date of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Child 2
Child 2 Name
Date Of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Child 3
Child 3 Name
Date of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Child 4
Child 4 Name
Date of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Child 5
Child 5 Name
Date of Birth
DD slash MM slash YYYY
Shevet (Or school year if unknown)
Child 6
Child 6 Name
Date of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
I can confirm that my child is available on the relevant dates and will attend all 5 sessions of the programme*
- Yes

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