Shabbaton Away 18th - 19th August, 2023 Registration Form Child First Name* Child Last Name* Parent First Name* Parent Middle Name Parent Last Name* Cost of Shabbaton is $130 but we do not want that to stand in the way of one of the batmi girls not attending so please speak with Reuvi if that is a challenge. Name on Credit Card* Credit Card Number* Expiry* January February March April May June July August September October November December 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 CVV Authority for my Child to Attend the Excursion: By signing the Authorisation for Excursion Form, I agree to and understand the following - My child has my permission to attend the excursion listed. I am listed on the child's Enrolment Form as a Parent or Authorised Nominee. I have read all of the details provided by the service and understand that I can access the Excursion Risk Assessment at the service. The contact details, including all emergency contact details, listed on my child's Enrolment Form are up-to-date. I agree to and understand the above. Date: E- signature: Sign on the line with your mouse or fingerReset Signature This page uses 128 bit SSL encryption to keep your data secure.