B’NEI MITZVAH PROGRAMME test

B'nei Mitzvah form

Child's name(Required)

Prefix First Last

Child's date of birth(Required)

Address(Required)

Address Line 1* City* Postcode*

Name of synagogue(Required)

Name of primary school(Required)

Name of secondary school your child attends or will be attending in September 2026(Required)

Date of Bar/Bat Mitzvah (Service/Ceremony date)(Required)

If you are having a Bat Mitzvah, please let us know where the service/ceremony will be taking place.(Required)

Parent first and last name(Required)

Parent first name* Parent last name*

Parent email(Required)

Parent contact number(Required)

Does your child have any medical conditions(Required)

Does your child have any allergies?(Required)

Please select your child’s T-shirt size below (please note this must see them through until May 2027)(Required)

I give permission for my child to have photos taken to be used for marketing purposes.(Required)

Where did you hear about our Camp Simcha Programme?(Required)

Please specify