Camp Agudah Shabbos

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Phone

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Student's Name*

First Last

Legal Name (if different)

First

Additional Students

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Second Student's Name

First Last

Third Student's Name

First Last

Father's Name

First Last

Mother's Name

First Last

Emergeny Contact*

First Last Phone Number

Allergies*

Yes

Please describe allergies

Important Information

Over 18

My son is over 18

Consent to go on trip*

I, the custodial parent/guardian of the minor listed above, by submitting this form, do hereby give permission for him to go with Ner Israel Yeshiva on a weekend trip (from June 18, 2026 to June 21, 2026) to Camp Agudah in Port Carling, ON.

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Category: Uncategorized

Camp Agudah Shabbos

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