Zach goes to Ezone

May 19 2-4PM

Participant's Name *
Participant's Name
Participants Cellphone Number *
Participants Cellphone Number
Parents' Cellphone Number *
Parents' Cellphone Number


By clicking "submit", we hereby grant our child permission to attend the Bnei Akiva Zach event In case of emergency we give permission for the designated First Aid provider to assist our child, and, if necessary, for him/her to be taken to a local doctor or hospital. We understand that any damage our child causes to the facilities around him/her or to property of others falls under our responsibility to replace and repair. We understand that Bnei Akiva is not responsible for any damage, theft or loss of personal items. We understand that if we withdraw our child from the event with three days’ notice or less, no refund will be given.