Tzofim Western Europe - Shachbag Seminar 24-26/1/2020

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THIS FORM MUST BE FILLED OUT BY A PARENT EVEN IF THE PARTICIPANT IS OVER 18 YEARS OF AGE

Halutz Parents: Please make sure that you have made payment for this event on the website www.tzofim-uk.org/special-events before you proceed:

Israeli Scouts Western Europe Seminar 2019

Participant's First name: *

Participant's Surname: *

Participant's Date of Birth *

YYYY

Activity Location: *

Please tick all appropriate answers *

My child can fully take part in the activity

My child can not take part in physical activity, such as long walking or running

My child may not take part in extreme activities such as absaling, wall climbing, zipwire etc.

My child can not swim.

Other, please use the space below to explain

Required

Please use the space below to tell us of any restrictions your child may have when taking part in the activity - or write NA *

Health issues and allergies should be known to us from the general Tzofim registration form. In addition, are there any other food issues we should know about?: *

My child is vegetarian

My child is vegan

No food issues

Other (use the space below)

Please use the space to tell us of anything we should know:

I have made full payment of £75.00 online via the website and this is my website order number (Amsterdam parents insert - AMS): *

Name of parent/carer *

Signing parent/carer email address *

Phone number of parent/carer during the activity *

Please give another phone number we can use in case of emergency, indicate who's number it is: *

Signature: *

I confirm that I have read all of the above and that I give my named child permission to attend this activity

Required

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