tafkid - Bnei Akiva UK

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Winter Machane Tafkid 5784

Step 1 of 5

20%

Tafkid*
- Junior Tafkid: Hadracha Madrich/a, Technical Madrich/a
- Senior Tafkid: Rosh, Sgan/it, Rakaz, TO & Medic
Email address*
Name*
First Last
Gender*
- Male
- Female
Date of birth
MM slash DD 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
- No
You will need a valid DBS before taking Machane. Please contact Hannah at [email protected] to arrange this.
Do you have Mas Chaver 5784? (you must have Mas Chaver 5784 to take Winter Machane)*
- Yes
- No
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?*
Would you consider any other Tafkid apart from the one you are applying for?*
Please feel free to Ari on [email protected] to discuss anything to do with Machane.

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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
Doctor's Phone Number*
Are you allergic to
- Penicillin
- Other Drugs
- Insect Bites
- Other
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
- No
Have you had any operations or serious injuries in the last 3 years?*
- Yes
- No
Do you suffer from any medical conditions or recurring illnesses?*
- Yes
- No
Will you be bringing any medication to Machane?*
- Yes
- No
Do you require use of an Epipen?*
- Yes
- No
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
- No
Please kindly give details*
Have you received counselling in the last 5 years?*
- Yes
- No
Please give details*
If you have any concerns and would like to speak to someone in confidence, please email the welfare team at [email protected] or call 0208 209 1319 ext.7
Do you have any dietary requirements?*
- Yes
- No
Dietary Requirements*

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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.

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References
Will this be your first time as a Madrich/a on a residential Machane*
- Yes
- No
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*

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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
- No
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 17th December – 28th December 2023 and I will attend Machane for its entire duration*
- Yes
- No
If not please give details
Terms and Conditions & Payment
Mas Chaver 5784*
- 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.
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 Winter Machane 5784 are: Pre camp: 17/12-20/12 Camp: 21/12-28/12 Please confirm you are available for ALL of these dates. If you are not you must speak to Abi ([email protected]) or Ari ([email protected])
I can attend camp*
- I am available
- I have spoken to Abi or Ari
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.
Signature
Total
£ 0.00
Credit Card
Card Details
Cardholder Name
What date are you making Aliyah and why? (wrong answers only)*

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If you would like more information about what we do

London

2 Hallswelle Road
London
NW11 0DJ
Tel: 0208 209 1319

Manchester

72 Singleton Road
Salford
Manchester
M7 4LU
Tel: 0161 740 1621

Our Policies

Constitution
Data Protection Policy
Customer Service Policy

Our Policies

Safeguarding Policy
Machane Terms & Conditions

© 2023 Bnei Akiva UK.

Camps
Svivot
Hachshara
Israel Machane
Education
Aliyah
Contact
Bachad
- DONATE
- LEGACY