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Gan Izzy Day Camp - Registration Form

Gan Izzy Day Camp - Registration Form

Government Childcare Benefit and Childcare Rebate (of up to 50%) as well as subsidies are available. To ensure you receive your eligible benefit, please make sure to include the Centrelink number and Date of Birth of both the camper and the parent when applying online. For both types of Government assistance, you will need to ensure your child is registered for Yeshivah Beth Rivkah Out of School Hours Care (Vacation Care).
IMPORTANT: If your child has not attended any overnight or day camps with Chabad Youth before please follow the link and enrol at
We also require a copy of your childs immunisation record. This is a mandatory requirement before acceptance into our daycamp.

For further information regarding government subsidies please contact Naomi or Ellie on 9528 8395 or email Please note: It is the responsibility of the parent to ensure we have the correct information in order to process your benefits. Your credit card will not be charged until after the benefits have been calculated.

Registration Information

Please take care when filling out the form that all information is correct. Incorrect information may result in your child not receiving a place in camp.

General Information:

Emergency Contact (other than Parents)

Medical Information


Please include all reasons and dosages. If not applicable you must enter the words 'Not Applicable'

Please include all reactions. Any allergies included will require allergy action plans to be provided. If not applicable you must enter the words 'Not Applicable'

If your child has a medical condition you are required to submit a medical condition management plan by email ( If not applicable you must enter the words 'Not Applicable'


Collecting your child from the Yeshivah Beth Rivkah VAC CARE premises

We recommend all children are to be picked up by a Parent or an Authorised Nominee directly from the Yeshivah Beth Rivkah VAC premises. An Authorised Nominee means a person who has been given permission by a parent or family member to collect the child from the education and care service.

If you would like for your child to walk home by themselves, or to a location to be picked up, in accordance with Regulation 99(4)(b), they will need to be signed out by a Yeshivah Beth Rivkah VAC staff member and/or volunteer before exiting the premises.

Please tick all that apply
Authorised Nominee #1
Authorised Nominee #2
Authorised Nominee #3
I hereby authorise Yeshivah/Beth Rivka OSHC staff and/or volunteers to photograph my child and use the photographs for any Yeshiva Beth Rivka OSHC for the following purposes:
Chabad Youth Staff have sighted my child's health care book: (office staff to complete)  YES _____ NO _____

Authorisation for Excursion Form:

Our service has organised an excursion for your child to attend. All of the relevant details are provided below for your convenience. The service has conducted an Excursion Risk Assessment which is available for your review upon request. For your child to attend, you are required to read this information and complete the Authority for Excursion Form. To complete this Form, you must be listed on the child’s enrolment record as either their parent or an Authorised Nominee.

Date of Excursions and destinations:
  • 15th January (Boys) 17th January (Girls)  - Rush HQ  (indoor obstacle zones) 39 S Corporate Ave, Rowville
  • 17th January (Boys) 18th January (Girls)  - Legoland (indoor educational play centre) Level 2, Chadstone Shopping Centre
  • 18th January (Boys) 15th January (Girls) - 234 Fun Galore (indoor play centre) 234 Ballarat Rd, Braybrook
  • 22nd January (Boys) 24th January (Girls) - TunzaFun (indoor fun park), Westfield Fountaingate, Princes Hwy Narre Warren
  • 24th January (Boys) 25th January (Girls) - Supa Zoo, 362 - 364 Boundary Rd, Dingley (indoor obstacle zones)
  • 25th January (Boys) 22nd January - Luna Park, 18 Lower Esplanade, St Kilda (amusement park)

Reason for excursion: Excursions during vacation care are for children to develop an understanding of belonging to groups and communities and to learn to interact in relation to others with care, empathy and respect. The excursions create a fun learning environment with physical activities.

Transportation Details (to and from): The most convenient and safest route as determined by the bus driver at the time. They will be going by private charter bus. All buses are equipped with seat belts. 

Staff to child ratio: Will be a minimum of 1:15. Up to 90 children with 6 staff and 9 volunteers.

The Period the Child will be Away from the Service Premises Children will be off premises for approx. 3 - 4 hours.

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. If not, I have provided the updated contact details above.
  • Sign on the line with your mouse or finger


COST: $65/daily (No partial weeks)

Please note payment MUST be recieved BEFORE your child attends camp.

Government subsidies are available. Payment will be processed after childcare deductions have been calculated.If you choose to pay by another method leave the credit card form blank, however your child's place will not be confirmed until your payment has been received.(There is a 3% surcharge for American Express payments.)



  • Cancellations in the lead up to camp incur $50 cancellation fee per child.
  •  Cancellations for camp must be in writing, no later than 7 days prior to the start of camp;


Before you submit:

1. Have you answered all the questions in full?

2. Does your child have a hubworks profile? If you are unsure, check with the office.

3. Have you sent your child's immunisation record through, they will not be accepted into camp without it.

Sign on the line with your mouse or finger