Machane Ari 5785 Application Form

Section 1: Applicant's Details

Machane Ari will be located at the London Bayit. Camp runs from 9.30am - 3.30pm.

Camp*

London (4th - 8th August)

Age group applying for?*

Year 3 - Hachana Aleph

Year 4 - Hachana Bet

Year 5 - Zeraim

Is this the applicant’s first time at Bnei Akiva Machane?*

Yes

No

Applicant's Name*

First Last

Gender*

Male

Female

Date of Birth*

Child’s E-mail

Child's Address

Child’s Mobile

My child will have a mobile phone:*

Yes

No

School*

School Year

Sviva

Other Sviva - Please specify

Any dietary restrictions e.g. vegetarian/vegan or food allergies:*

Yes

No

Children will bring their own lunch and snacks to Machane Ari, but some activities will involve food. Bnei Akiva is a nut and sesame free zone, and all food brought onto the premises must be strictly kosher.

Please specify any dietary restrictions in the box below*

T-Shirt Size*

Upload a Photo*

Max. file size: 50 MB.

Please upload a current photo of the child applying. This will enable us to identify and safeguard your child whilst at Machane

Parent/Guardian 1

Title*

Name*

First Last

Address*

Street Address City Post Code Country

Use this address for:

General Correspondence

Invoicing

Child's Address

Telephone (Home)*

Telephone (Mobile)*

Email*

Synagogue*

Marital Status

Parent/Guardian 2

Title

Name

First Last

Address

Street Address City Post Code Country

Use this address for:

General Correspondence

Invoicing

Child's Address

Telephone (Home)

Telephone (Mobile)

Email

Synagogue

Marital Status

Section 4: Emergency Contact Details

In case of an emergency and in the event that you cannot be contacted, kindly give an alternative contact. This person must be prepared and able to collect your child from camp should they need to return early.

PLEASE NOTE, THIS EMERGENCY CONTACT MUST NOT BE THE APPLICANT’S PARENT.

Emergency Contact Name*

Relationship to child (Not Parent)*

Emergency Contact's Address*

Street Address City Post Code

Emergency Contact's Telephone (Home)*

Emergency Contact's Telephone (Mobile)*

Emergency Contact's Email*

Who will be picking up your child from Camp?

This can be changed nearer the time by emailing us at camps@bauk.org

Section 5: Membership & Data Protection

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 right at its discretion to revoke membership in line with the Articles of Association and Standing Orders of the Movement.

Data Protection Act 1998
General Data Protection Regulations (GDPR) 2018
All data supplied will be recorded and held electronically in Bnei Akiva's secure database. All data requested is considered necessary for the safe and efficient running of Bnei Akiva Camps and Events. We only request data that we consider to be relevant and make every effort not to request data which might be considered excessive for the purpose. Access to all data held is strictly controlled and is only accessible to Bnei Akiva employees who require such access in order to properly carry out their jobs. Information will not be disclosed to any third party member without your consent. Please feel free to read our full Data Protection Policy at bauk.org
I agree my child will only bring to camp the medication declared above.

I have read the above and agree that if it is felt necessary Bnei Akiva can administer my child over the counter medication.

I have declared any drug/medical treatment which my child may be allergic to (this may include the use of plasters & bandages, Paracetamol, Ibuprofen, etc.).

In the event of any accident or illness during camp, Bnei Akiva will make every endeavour to contact the child’s parent/guardian/emergency guardian. If I cannot be contacted, I hereby authorise any medical, surgical or dental procedure that a registered practitioner deems necessary for my child. I further authorise qualified practitioners to administer anaesthetic to this child if such an eventuality arises. I undertake to pay any medical or dental fees and/or cost incurred in this regard that is not covered by insurance.

In the event of my child being sent home from Machane due to health or behaviour issues, I agree that it is the responsibility of the parent/guardian/emergency contact to pick up the child, and pay for any expenses incurred.

My child and I have read and understood the behaviour agreement and appreciate that s/he must act in accordance with them whilst under the auspices of Bnei Akiva Camp.

I am happy for Bnei Akiva to take photos of my child which may be used publicly by Bnei Akiva.*

Yes

No

I am happy for myself and family members under my care to be contacted by Bnei Akiva and Friends of Bnei Akiva (Bachad) for matters related to future programmes, general updates, and fundraising campaigns.

Agree

If you would like any further details about how and why we might contact you, or if you would like to make any specific changes to the above, please contact operations@bauk.org

Section 6: Confirmation & Behaviour Agreement

Click on the link below for the Machane Code of Conduct, and Terms & Conditions. These constitute your contract with Bnei Akiva. Please read this through with the child/ren you are applying for and ensure you and they are aware of the obligations it entails:

Machane Code of Conduct

Please take time to read through our First Aid Policy:

Machane First Aid Policy

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 child arriving at camp.

I understand that I must disclose any pertinent safeguarding information to our Designated Protection Officer (DSO) prior to attending Bnei Akiva activities. Bnei Akiva upholds information-sharing procedures compatible with LSCB guidelines, and will work in a sensitive and confidential manner to ensure the highest level of safeguarding for your child.

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

I understand the Insurance Group Policy will become void if pre-existing medical information has not been declared.

I have noted that it is Bnei Akiva’s practice to provide over the counter medication at camp and I have declared any allergies that my child may have to such medication on this form. If for any reason it is deemed necessary, I accept that my child will be taken to visit the local doctor and/or hospital.

If my child becomes ill before camp, Bnei Akiva will require a doctor’s letter stating that my child is fit and well enough to attend.

All medication must be handed in at the beginning of camp for safety reasons. I will inform my child of this before s/he leaves for camp. Additionally, I will not send my child to camp with any extra medication that has not been declared as this comprises a danger to both my child and other children.

I confirm that I have read and agree with these Terms and Conditions, as well as the Machane Code of Conduct and First Aid Policy*

Yes

No

You must agree to our terms and conditions to continue.