Family Name
Student's First Name
Gender Male Female 2
Date of Birth
Age
Address
Postcode
Country
Email
First Name of Parent or Guardian
Family Name of Parent or Guardian
Home Telephone
Business Telephone
Mobile
Fax
Telephone Number during period of Camp if different from above:
Nationality
Name of School/College
Mother Tongue
2nd Language
Level of Judaism Orthodox Modern Orthodox Conservative Liberal Traditional
Do you wish to share with a friend/s ? Yes No
If yes, please give name of friend/s
Does he/she have any allergies, special dietary requirements or medical Care Yes No
If yes, please specify
Are you travelling to China independently or joining an escorted group Travelling independently Joining an escorted group from Tel Aviv Joining an escorted group from London Joining an escorted group from New York
How did you hear about JCamps? Friend Internet Relative School Newspaper Advertisement Other 7
Travel & Insurance Please provide details of your insurance, which is compulsory, and must include travel, medical expenses, personal accident, cancellation & curtailment, baggage, personal property & money, travel delay and persona lliability.
Please contact us for prices in your currency Euro or Dollar or Sterling.Camp Fees include Accommodation, Full board, Activities, Excursions, and Evening programme.
A £600 (US$900) deposit is required for Application to be confirmed.
By Cheque made payable to JCamps Yes No
or By Bank Transfer in Sterling, Euros or Dollars Yes No
Bank: Natwest Bank PLC Address: PO Box 113, Cavell House, 2a Charing Cross Road, London WC2H 0PD Sort Code: 60-40-05 Account No: 550-00-35018798 IBANNo: GB98 NWBK 6072 1435 0187 98 BIC: NWBK GB 2L Account Name: JCamps NB: Please add £15 (sterling) to cheques and Bank Transfers to cover UK bank charges. Conversion from other currencies to sterling will be at NatWest Bank buying rate on date of Bank conversion.
Terms and Conditions (required) This box must be ticked. Part or full payment is regarded as your acceptance of them. terms and conditions I confirm that I have read and agree to the terms and conditions.
SUMMER CAMP DATES JULY 19 - AUGUST 6 (19 days) AGES 15 -19 YEARS
