Step 1 of 6 16% This field is hidden when viewing the formThis form is currently not accepting new signupsIf you have any questions please speak with the Rosh Machane at camp@bneiakiva.com.au. If you have been provided a code to continue signup, please enter it here.This field is hidden when viewing the formSignup CodeParent Name(Required) First Last Parent Mobile Number(Required)Parent Email(Required) Enter Email Confirm Email State of Residence(Required)VICNSWWANew ZealandPlease Note: Bnei Akiva Australia will not be organising interstate flights for Fed Camp this year.You will need to make organise your own transport into Melbourne. If you would like help finding a flight, please reach out to us at camp@bneiakiva.com.auTo apply for a Subsidy/Payment plan, please click here to fill out the subsidy application form. If you have applied for a subsidy, please check the box below. You can continue to sign up, however you will not be able to complete the sign up. When you reach payment stage, please choose Save and Continue Later. Once a subsidy has been approved, you will receive an email with instructions to complete the signup.Subsidy Subsidised Cost Child SignupAs part of the signups, you will need to provide the following medical information. For security reasons, this data is not able to be autosaved whilst it is being entered it in. Progress will only be saved at the completion of this section, when you press Add Child. We recommend completing this part in one session.Medical details: Medicare number Private Healthcare details Allergy information (including management plans) Asthma information (including management plans) Medical information (including management plans) Date of last tetanus Dietary requirementsIf you do not have this information onhand, we recommend getting this information ready before signing up.Child Entries Row ID Child's Name Year Level Actions Edit Delete Add Child Maximum number of children reached. Family Doctor(Required)Family Doctor Phone(Required)Please include the appropriate area code. Emergency ContactsEmergency Contact 1 Name(Required)Emergency Contact 1 Relationship to Participant(s)(Required)MotherFatherGrandparentStep-parentLegal guardianCousinOtherEmergency Contact 1 Phone(Required)Alternative Contact Name(Required)Alternative Contact Relationship to Participant(s)(Required)MotherFatherGrandparentStep-parentLegal guardianCousinOtherAlternative Contact Phone(Required) MerchFederal Bnei Akiva is proud to offer a choice of extra Merch, in addition to the camp t-shirt that every chanich will be provided.Tote Bag Quantity Price: $ 10.00 Quantity Sunglasses Quantity Price: $ 8.50 Quantity Bucket Hat Quantity Price: $ 12.50 Quantity Water Bottle Quantity Price: $ 15.00 Quantity DonationIn our incredible Australian Jewish community, there are unfortunately many families who are unable to afford the cost of camp. It is our priority at Bnei Akiva to make camp accessible to every child aiding them in their personal growth and Jewish development. However this commitment comes at a significant financial burden for Bnei Akiva. We therefore ask that you consider making a donation towards this fund which is directed exclusively towards providing for those children who may otherwise be unable to attend camp. We thank you for your consideration and generosity. If the amount below does not reflect your subsidised amount, please click the link below. Subsidy Page PaymentCamp Cost (Total) Price: $ 0.00 Subsidy Code Total If you see this and can't find subsidy information or the save and continue later page, please reload the page. If you are on a Mac, press Command+R. If you are on Windows, press Control+RCredit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name
