Summer Machane Tafkidim 5785

The dates for summer Machane are:
Pre-camp: 22nd-28th July
Machane: 29th-11th August

Tafkid*

Junior Tafkid: Hadracha Madrich/a, Technical Madrich/a

Senior Tafkid: Rosh, Sgan/it, Rakaz, TO, Head Cook & Medic

Name*

First Last

Email address*

Date of birth*

DD slash MM slash YYYY

Shevet (or if not known year group)*

Mobile Number*

Address*

Street Address ZIP / Postal Code Country

Do you have a current DBS?*

Yes

You will need a valid DBS before taking Machane. Please contact Simon at camps@bauk.org to arrange this.

Do you have Mas Chaver 5785? (you must have Mas Chaver 5785 to take Summer Machane)*

Yes

Give a summary of your involvement with Bnei Akiva to date*

What are you doing this year?*

Why do you want to be involved in Bnei Akiva Machane?*

Which Tafkid are you applying for?*

Please note this is not a guarantee of a specific tafkid.

Which Tafkid are you applying for?*

Please note this is not a guarantee of a specific tafkid.

Would you consider any other Tafkid?*

Hadracha Madrich/a

Technical Madrich/a

Rosh

Sgan/it

Head Cook

Medic

T.O.

Rakaz

I would not consider any other Tafkid

Please feel free to contact Simon at camps@bauk.org to discuss anything to do with Machane.

Medical Details

Please disclose all medical information and requirements to allow us to fully support you. Failure to disclose information may lead to removal from Machane.

Doctor's name*

Doctor's address*

Street Address City ZIP / Postal Code Country

Doctor's Phone Number*

Are you allergic to

Penicillin

Other Drugs

Insect Bites

Other

Please give details

Have you lived outside of the UK for more than 3 months in the past five years?

Yes

Please give details

Have you been vaccinated against the following:

Mumps

Measles

German measles

Chicken pox

Whooping cough

Do you suffer from any of the following

Asthma

Hyperventilation

Skin Disorder

Diabetes

Hayfever

Have you suffered from any infectious diseases e.g. glandular fever?*

Yes

Have you had any operations or serious injuries in the last 3 years?*

Yes

Do you suffer from any medical conditions or recurring illnesses?*

Yes

Will you be bringing any medication to Machane?*

Yes

Do you require use of an Epipen?*

Yes

If you have answered yes to any of the above, please give details below

What was the date of your last tetanus? (if this was more than 10 years ago you will need to get another one before Machane)*

Do you suffer from any conditions that we should be aware of? (E.g. ADHD/OCD/Eating disorders/emotional stress/self-harming/other mental health conditions)*

Yes

Please kindly give details*

Have you received counselling in the last 5 years?*

Yes

Please give details*

If you have any concerns and would like to speak to someone in confidence, please email the Sarah Peston at welfare@bauk.org or call 0208 209 1319 ext.7

Do you have any dietary requirements?*

Yes

Dietary Requirements*

Emergency Contact Details

Please provide the contact information of someone who will be available for the entire duration of Machane.

Name*

First Last

Relation to you*

Emergency Contact Phone Number*

Emergency Contact Email

If Bnei Akiva are worried about the state of your mental or physical health, the Designated Safeguarding Officer or Mazkira will contact your emergency contact.

References

Will this be your first time as a Madrich/a on a residential Machane*

Yes

Please select Yes only once you have been on H-Course

Reference 1 Name*

First Last

Reference 1 Position (must be someone who has held a senior position in Bnei Akiva)*

Reference 1 Phone*

Reference 1 Email*

Reference 2 Name ( Must an official within an educational institution, not Bnei Akiva)*

First Last

Reference 2 Position*

Reference 2 Phone*

Reference 2 Email*

Insurance Details/Disclaimers

By selecting Yes you agree that Bnei Akiva has permission to take photos of you that may be used publicly by Bnei Akiva E.g. advertising*

Yes

I give permission for Bnei Akiva and Friends of Bnei Akiva (Bachad) to contact me in regards to upcoming events, news and fundraising activities in the future

Agree

I can confirm that I will be available between the dates 22nd of July to the 11th of August 2025, and that I will attend Machane for its entire duration*

Yes

If not please give details

Terms and Conditions & Payment

Mas Chaver 5785*

I would like to pay for family Mas Chaver - £93

I would like to pay now for individual membership for Yr12/13 - £53

I would like to pay now for Bogrim's membership - £20

Please invoice me for Mas Chaver

Mas Chaver runs from Rosh Hashanah to Rosh Hashanah.

Would you like to be covered by the Bnei Akiva insurance policy?*

Yes - please invoice me for insurance

No - I will be responsible for my own insurance

1) Membership of Bnei Akiva is available only to persons of the Jewish Religion according to the rulings of the Office of the Chief Rabbi.

2) Membership lasts for 1 Jewish year only Rosh Hashanah to Rosh Hashanah and must be renewed accordingly.

3) The supply of incorrect information may at the discretion of Bnei Akiva render membership invalid.

4) Bnei Akiva reserves the rights at its discretion to revoke membership for any reason it sees fit.

The dates of Summer Machane 5785 are: Precamp: 22nd-28th Camp 29th-11th

Please confirm you are available for ALL of these dates. If you are not you must speak to Michal (mazkira@bauk.org) or Simon (camps@bauk.org)

I hereby declare that to the best of my knowledge, this form is accurate and complete . I understand that Bnei Akiva will not be responsible for any medical condition either physical or emotional, resulting from my failure to disclose relevant information prior to my arrival at camp.

I understand that pre-existing conditions that have not been declared may result in me being returned home immediately at my expense and no refund given.

I agree with the terms and conditions*

Agree

I am happy that all the information I have provided is accurate, and I agree with all conditions of this form.

There is an elite game known as: Chavruta, Roommate, Broygus (+ Bonus: Friday Night dinner) [if unfamiliar google: snog, marry, avoid or kiss, marry, kill] Please assign each of the mazkirut to these roles and explain your reasoning*

Assign Michal, Sam, Simon & Rafi to these options

Signature*

Mas Chaver 5785

Price:

Mas Chaver 5785

Price:

Mas Chaver 5785

Price:

Mas Chaver 5785

Price:

First Time Madrich/a Fee

IMPORTANT: Please note, submission of this form does not ensure your acceptance to Machane. If you are not accepted as a madrich/a, your fee will be refunded in full

Price:

Total

Credit Card

Card Details

Cardholder Name

Summer Machane 5785 Tafkidim Applications

Medical Details

Emergency Contact Details

References

Insurance Details/Disclaimers

Terms and Conditions & Payment

London

Manchester

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