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Full Name

Date of birth

Email

Phone number

Country of Residence

Passport (jpg, pdf or png)

Allergies or food restrictions

Selfie (jpg, pdf or png)

How many Camp Ketzev Latino-Israeli have you been to?

First timer, im ready to be surprised. I went only once before and so ready to be back. I am a top fan, haven’t missed any

Health care insurace

Yes No

If your answer is yes

Insurance name & policy number

Emergency contact

Name

Telephone

Nickname

Did someone refer or recommend the camp to you?

T-shirt Cut

Women Cut Men Cut

T-Shirt Size

Small Medium Large X-Large

Shoe Size (US size)

Room Type

Single Double Triple Quadruple (2 beds)

Roommate 1

Roommate 2

Roommate 3

Favorite dances

What do you like to dance?

Circles Couples Lines

Level

Beginners Intermediate Advanced

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