Application and Medical Form for Summer Machane

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

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.

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.

Please take time to read through our First Aid Policy:

Machane First Aid Policy

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.

Cancellation Policy:

Cancellations after the application Deadline will be refunded as follows:

- 6 weeks or more prior to camp – 100% (less an admin fee of £75)

- Cancellation within 6 weeks of departure, no refund.

PLEASE NOTE: Mas Chaver or camp insurance will NOT be refunded in all the above cases.