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hendon ha’irgun 5786!
Step
1
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3
33%
Parent Details
Event
Hendon Shabbat Ha’Irgun
Parent 1 Name (Primary Contact)
*
First
Last
Email
*
Parent 2 Name
First
Last
Email
Primary Contact Phone (Mob.)
*
Who will be attending Family friday night :
Parent 1
Parent 2
Parent one attending FFN name
Parent two attending FFN name
Address
*
Street Address
Address Line 2
City
County / State / Region
ZIP / Postal Code
Unless otherwise stated, the primary contact will also be considered the Emergency Contact for all children listed on this form. Would you like to include an alternate Emergency Contact?
*
Yes
No
Please give Emergency Contact details below, and state which child/ren they are responsible for:
Children's Details
How many children are you booking for?
One
Two
Three
Four
Five
Six
Child 1
Child 1 Name
Date of Birth
DD slash MM slash YYYY
School
Shevet
Atid (Year 1/2)
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)
Chavraya Gimmel (Year 10+)
Will be attending:
Child – High school age, Family Friday night – £12.50
Child- Primary school age, Family Friday night- £10
Child – Shabbat Lunch – £10.00
Child- Motzei Tochnit- £7
Does this child have any dietary/medical requirements, or allergies?
Yes
No
Please give details below:
Child 2
Child 2 Name
Date of Birth
DD slash MM slash YYYY
School
Shevet
Atid (Year 1/2)
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)
Chavraya Gimmel (Year 10+)
Will be attending:
Child – High School age, Family Friday night – £12.50
Child- Primary school age, Family Friday night- £10
Child – Shabbat Lunch – £10
Child- Motzei Tochnit- £7
Does this child have any dietary/medical requirements, or allergies?
Yes
No
Please give details below:
Child 3
Child 3 Name
Date of Birth
DD slash MM slash YYYY
School
Shevet
Atid (Year 1/2)
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)
Chavraya Gimmel (Year 10+)
Will be attending:
Child – High school age, Family Friday night – £12.50
Child- Primary School, Family Friday night- £10
Child – Shabbat Lunch – £10
Child- Motzei Tochnit- £7
Does this child have any dietary/medical requirements, or allergies?
Yes
No
Please give details below:
Child 4
Child 4 Name
Date of Birth
DD slash MM slash YYYY
School
Shevet
Atid (Year 1/2)
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)
Chavraya Gimmel (Year 10+)
Will be attending:
Child – High school age, Family Friday night- £12.50
Child-Primary school age, Friday night dinner- £10
Child – Shabbat Lunch – £10
Child- Motzei Tochnit- £7
Does this child have any dietary/medical requirements, or allergies?
Yes
No
Please give details below:
Child 5
Child 5 Name
Date of Birth
DD slash MM slash YYYY
School
Shevet
Atid (Year 1/2)
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)
Chavraya Gimmel (Year 10+)
Will be attending:
Child – High school age, Family Friday night
Child- Primary school age, Family Friday night
Child-Shabbat Lunch-£10
Child- Motzei Tochnit- £7
Does this child have any dietary/medical requirements, or allergies?
Yes
No
Please give details below:
Child 6
Child 6 Name
Date of Birth
DD slash MM slash YYYY
School
Shevet
Atid (Year 1/2)
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)
Chavraya Gimmel (Year 10+)
Will be attending:
Child high school age, Family Friday Night – £12.50
Child primary school age, Family Friday night
Child- Shabbat lunch
Child – Motzei Shabbat Movie Night – £7
Does this child have any dietary/medical requirements, or allergies?
Yes
No
Please give details below:
Booking & Payment
Mas Chaver is membership of Bnei Akiva, and runs from Rosh Hashanah to Rosh Hashanah. Mas Chaver for this year (5785) began in September 2024 and you would have paid if you attended Winter Machane.
Family discount ticket (2 adults 3 children)
Quantity
Price:
£ 50.00
Quantity
Adult tickets
Quantity
Price:
£ 15.00
Quantity
Child in secondary school – Friday Night Dinner
Quantity
Price:
£ 12.50
Quantity
Child in Primary School – Friday Night Dinner
Quantity
Price:
£ 10.00
Quantity
Shabbat Lunch – All Children
Quantity
Price:
£ 10.00
Quantity
Child motzei Tochnit- £7
Quantity
Price:
£ 7.00
Quantity
Mas Chaver (Membership)
Family Membership – £95
Individual Membership – £53
I already have Mas Chaver for 5784
I do not wish to purchase Mas Chaver at this time
If you are paying for participants not in your family, they will need to arrange their own Mas Chaver by visiting bauk.org/mas-chaver
Please note, we would never want anyone to miss out on a Bnei Akiva event due to financial reasons. We therefore have funds available to help families in need of extra financial support. Please get in touch with Michal via mazkira@bauk.org in confidence.
I would like to donate a different amount of:
I am happy for Bnei Akiva and Friends of Bnei Akiva (BACHAD) to contact me about future events and news.
*
Yes
No
Total
£ 0.00
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