Gan Yisroel Winter Overnight Camps form July 2025

Camper 1 Full Name*

1 First Name 1 Last Name

Camper 1 Camp Attending*

Camper 1 Birth Date*

1 Month 1 Day 1 Year

Camper 1 School Yr*

Camper 2 Full Name

2 First Name 2 Last Name

Camper 2 camp attending

Camper 2 Birth Date

2 Month 2 Day 2 Year

Camper 2 School Yr

Camper 3 Full Name

3 First Name 3 Last Name

Camper 3 camp attending

Camper 3 Birth Date

3 Month 3 Day 3 Year

Camper 3 School Yr

Parent / Guardian Name*

Prefix First Name Last Name

Parent / Guardian Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail*

I would like to receive news and updates by email

Phone Number*

Area Code Phone Number

Emergency contact*

First Name Last Name

Relationship to child*

Phone Number*

Area Code Phone Number

Medical information:*

Expiry Date*

Private hospital insurance fund and number

Full list of all current medications and dosages

Drug allergies

Any medical conditions (past and current) *

Date of latest booster (including ADT, triple antigen, infanrix or CDT vaccines)

Local GP: name, address, office phone and after hours phone/mobile*

Consent to Chabad Youth NSW capturing and using photos/videos of my child/ren for marketing and promotional purposes, including social media, websites, and printed materials.*

YesNo

I/We give permission for this child to*

Participate in outings to onsite activities such as mountain biking, hiking and othersHave SPF50+ sunscreen applied prior to sun exposureHave Band-Aids or sticking plasters applied when necessaryBe given Panadol or Nurfogen if and when necessary without a phone call (A call will usually be placed prior to parents)

I/We agree that our child/ren will obey, understand and accept: *

The NO alcohol or drug policyNo smoking or vaping during camp timesNo phone policy during camp (Phones will be provided to call home before Shabbos)

Camp will provide Healthy Meals, Snacks and Drinks throughout camp

Payment Options:

The Early Bird Rate cost per child for Overnight camp is $750 (ONLY if paid in full before 1 July)
The Full Rate cost per child for Overnight camp is $900

*All above-listed rates are already highly subsidised by Chabad Youth NSW.

All fees must be paid by 07/07/2025 - if you have only paid the deposit, your card will be charged the remainder

To apply for a subsidy through the Gan Yisroel Subsidy Fund, please click HERE

Full Payment must be provided before camp.

There will be no refunds for cancellations or absences.

The camp fees are structured as follows: The Early Bird Rate is $750 per child, provided that full payment is made by 1 July. The Full Rate is $900 per child for registrations made after this date. A minimum deposit of $150 is required at the time of registration to secure a spot.*

Deposit $100 AUD$150 per month over the next 4 monthsFull Rate $900Early Bird $750 (ends 9am 1 July)

Payment amount

Total

$0.00 AUD

Yes, I'd like to donate the cost of processing this transaction by adding 2%

Payment*

Credit Card

We accept Visa, MasterCard, American Express
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

For a full list of our Policies and Procedures, please click here

I hereby accept that Sydney Talmudical College Association, Lubavitch Jewish Centre, Chabad Youth NSW, Chabad North Shore or their employees and agents, bear no responsibility for any harm or injury that might befall my child. In the event of my child becoming ill or injured during the course of camp, I authorise the above mentioned entities to take the necessary steps to ensure that my child receives appropriate medical attention, for which I will accept full payment for any costs incurred.

I acknowledge that my child will be participating in camp activities both within and outside the camp venue grounds. I authorise my child to participate in these activities.

I hereby indemnify Sydney Talmudical College Association, Lubavitch Jewish Centre, Chabad Youth NSW, Chabad North Shore, their employees and agents, for any demands, claims, actions or suits made against any of them, by any person, arising from or in relation to any act or omission by my child.

Cancellations made before 22 June 2025 will incur a $100 fee per enrolment.

From 22 June 2025 onwards, the full camp fee will be charged.

Cancellations must be submitted in writing to [email protected].

If cancelled due to medical reasons (with a doctor's certificate), 50% of the fee will be charged.

No refunds will be provided once the child departs for camp or if the child leaves early.

In the event of evacuation (e.g. bushfire), no refund will be provided for remaining days.

If Chabad Youth NSW is unable to run the camp, no charges will apply.

Any early departures must be pre-arranged in writing before camp begins.

Parent / Guardian*

First Name Last Name

Date*

Month Day Year

at Hour Minutes

For more information please call Elimelech on 0433 549 190 or Avremi on 0404 032 166 or email [email protected]

Gan Yisroel Winter Overnight Camps form July 2025

Gan Yisroel Winter Overnight Camps 2025

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