Bus – Mesivta Lubavitch Toronto

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Bachur Name*

First Middle Last

Parents Names*

Father Mother Last Name

Email*

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Consent*

We consent for Mesivta Lubavitch Toronto (MLT) to take our son to to the Camp grounds of Gan Yisroel Montreal, QC.

I Agree*

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Financial Responsibility*

We will be financially responsible for any damages that were caused by our son whether done willfully or inadvertently. Final determination will be made by the Mesivta Hanhala or Camp personnel

I Agree*

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Medical*

I have Medical insurance/OHIP that extends to Canada and is valid through the summer schedule. We further hold MLT harmless of any liability.

I Agree*

TRAVEL PLANS

Mesivta is arranging buses to ease the transportation to and from Camp.
June 22: Mesivta to Camp CGI $77
July 26: Return To Toronto $98 To 770 $115

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Transportation*

To CGI & return to Toronto
To CGI & return to 770
To CGI only
Other

Other transportation*

CARING PARENTS

While we did not make this decision conditional on additional financial participation from parents, please do understand that this is a great undertaking. The additional cost per Talmid is well over $1000 and we cannot do this without your help. I would be incredibly grateful for your financial assistance to enhance the summer zman for OUR children.

I will IYH participate by*

Donating $500 (Hishtatfus)
Donating $1000 (Cover one Bachur)
Donating $1500 (Cover my Bachur & assist another)
Donating $5,000 - make it happen
I have already sent my participation
I cannot assist at the time
Other

Other Amount*

Total

$0.00

Billing Address (of credit card)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Notes

Donation

TRAVEL PLANS

CARING PARENTS