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Join us for an evening of fun games at a university near you
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IN ORDER TO BEST CARE FOR YOUR CHILD, WE REQUIRE ALL PARTICIANTS OF SVIVA EVENTS TO HAVE FILLED OUT THE SVIVA MEDICAL FORM. IF YOU HAVE NOT ALREADY DONE SO, PLEASE VISIT https://www.bauk.org/svivot-medical-form/ BEFORE THEY ATTEND
Which Sviva will your children be attending?
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Woodside park
Name (Primary Contact)
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First
Last
Email
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Primary Contact Phone (Mob.)
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Children's Details
How many children are you booking for?
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1
2
3
4
Child 1
Child 1 Name
*
Date of Birth
*
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Hachana Aleph (Year 3)
Hachana Bet (Year 4)
Zeraim (Year 5)
Nitzanim (Year 6)
Ma'alot (Year 7)
Ma'apilim (Year 8)
Haroeh (year 9)
Shevet X (year 10)
Any Allergies or Dietary Requirements?
Child 2
Child 2 Name
Date Of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Hachana Aleph (Year 3)
Hachana Bet (Year 4)
Zeraim (Year 5)
Nitzanim (Year 6)
Ma'alot (Year 7)
Ma'apilim (Year 8)
Haroeh (year 9)
Shevet X (year 10)
Any Allergies or Dietary Requirements?
Child 3
Child 3 Name
Date of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Atid (Year 2)
Hachana Aleph (Year 3)
Hachana Bet (Year 4)
Zeraim (Year 5)
Nitzanim (Year 6)
Ma'alot (Year 7)
Ma'apilim (Year 8)
Haroeh (year 9)
Shevet X (year 10)
Any Allergies or Dietary Requirements?
Child 4
Child 4 Name
Date of Birth
DD slash MM slash YYYY
Shevet (Or school year if unkown)
Hachana Aleph (Year 3)
Hachana Bet (Year 4)
Zeraim (Year 5)
Nitzanim (Year 6)
Ma'alot (Year 7)
Ma'apilim (Year 8)
Haroeh (year 9)
Shevet X (year 10)
Any Allergies or Dietary Requirements?
Payment
Games night ticket x1
*
Price:
Games Night Ticket x2
*
Price:
Games Night Ticket x3
*
Price:
Games Movie Night Ticket x4
*
Price:
Total
Credit Card
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Hachshara
Israel Machane
Otzar Torah MiTzion
Aliyah
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Bachad
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