Ride The Trail.
Discover Your Path.
Get Into Geerz.

Family Registration: 2022-2023 Season Israel

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Welcome Aboard!


1. Please note that completing this registration form is absolutely mandatory for attending any geerz riding sessions.

2. Please note that registration does not guarantee your child a spot, as groups fill up quickly. We will make every effort to accommodate all families.

3. For further information, click here.

IF:

(1) You are a returning family from last year;

OR

(2) You are a family who signed up this year
and wishes to register an additional child,

THEN:

Please enter your email here:


Please first select your city

 
 
 
 
 
Thank you so much for your interest in Geerz. We are opening groups in new cities all the time, so please fill out the information below, and if there is sufficient demand, we will open a group in your city and contact you. Thank you!
 
We do not have final confirmation that a Geerz group will open in your city. Please complete the registration process, and we will contact you as soon as your city's status is confirmed.
*City
RBS Families please select 'Ramat Beit Shemesh' and *not* 'Beit Shemesh'
*Specify City
*Gender
*Email
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
General Comments
Please enter here any general information about your *family* that you'd like us to be aware of.

Parent Info

*Family Type
 
Orange fields required. Leave others blank, unless different from parent 1
 

Parent / Guardian 1

Parent / Guardian 2

*Parent / Guardian Type
*First Name
*Last Name (English)
*Last Name (Hebrew)
*Email
*Mobile Phone
*Do you have WhatsApp?
*U.S. WhatsApp #
Area code    Phone
*Preferred Language
Family Situation
Any additional family circumstances we should be aware of. All information will be treated with the highest level of confidentiality.

Contact Information

Home Phone
Fax
Website
*Mailing Address
*Emergency Contact Person
Please enter someone other than the participant's parents
*Emergency Contact Phone
*Relationship to Participant

Scheduling Preferences

Top Preference
Day:     Time: :
Second Preference
Day:     Time: :
Day:     Time: :

General Information

*May we use your children's photos for publicity?
Geerz relies on the generosity of our donors to make our program available to hundreds of needy kids. Pictures play a big role in this.
*Which Kuppat Cholim do you belong to?
*Specify
General Comments
Please enter here any general information about your *family* that you'd like us to be aware of.

Information About Your Children

Child # 1

 
*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Child # 2

 
*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Child # 3

 
*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Child # 4

 
*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Sign Up Additional Children

*How many [new ]children are you signing up?

Child # 1

*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Child # 2

*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Child # 3

*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Child # 4

*First Name (English)
*First Name (Hebrew)
*Gender
*Date of Birth
Child must be at least 7 by the start of the coming year. When using the calendar feature, be sure to click on the day.
*Identification Document
*Document No.
*Document No.
*Country
*School
*Specify
*Grade for the school year 2022-2023
*Shirt Size
*Does your child have any medical conditions we should be aware of?
This confidential information will be shared with the instructor and ride coordinator alone.
*Please specify
*Does your child suffer from allergies?
*Please specify
Any requests that your child be grouped with friends?
Comments
Please enter here any general information about your *child* that you'd like us to be aware of.

Acceptance of Waiver

 
After reading and indicating your agreement with the Waiver, please enter your Teudat Zehut (or, if you don't have one, your Passport number). This is your electronic signature to your acceptance of our Waiver.
 I agree with the  Geerz Waiver and Release
*Identification Document - Parent 1
*Document No.
*Document No.
*Country
*Identification Document - Parent 2
*Document No.
*Document No.
*Country

Price

 
Although the actual cost to Geerz per child for the Geerz professional therapeutic program is 4,500 ₪, the program is heavily subsidized thanks to the generosity of our donors, and Geerz participants enjoy our quality program, with a price to you the parent similar to other after-school programs in your city.
Amount Due
Amount will appear when you select city   
Amount paid to date
Balance due

Discount

 
Discounts are available for families experiencing financial hardship. Please read the conditions to see if you qualify.
*I would like to request a scholarship
*Scholarship Amount Requested ₪
 

Payment

*I will pay now online
*I will pay now online
 

Before you continue to payment...


1. Please note that we don't accept Israeli Amex / Diners credit cards.

2. Please do *not* use "Tashlumim" (Installments) if you are using an American credit card.

3. Please make sure that the address you enter matches the one listed on the credit card you use.
 

Paying A Deposit


1. Children who register and are accepted are welcome to attend the first session of the season as a free trial ride.

2. However, a non-refundable 50 ILS deposit per child is required to secure a spot and receive the geerz riding jersey, which is mandatory for all sessions.

3. This deposit will be applied towards the total amount due for families who decide to remain.

4. Once you decide to join Geerz, you are required to either pay in full, or to arrange payment in up to 10 monthly installments. Please make sure that this is done by your child's second Geerz session. If your payment is not arranged by 15/12/2022, your credit card will be charged the full amount of the balance due. Without arranging payment, your child will be unable to attend further sessions.

Paying A Deposit


1. Children who register and are accepted are welcome to attend the first session of the season as a free trial ride.

2. However, a non-refundable 50 ILS deposit per child is required to secure a spot and receive the geerz riding jersey, which is mandatory for all sessions.

3. This deposit will be applied towards the total amount due for families who decide to remain.

4. Once you decide to join Geerz, you are required to either pay in full, or to arrange payment in up to 10 monthly installments. Please make sure that this is done by your child's second Geerz session. If your payment is not arranged by 15/12/2022, your credit card will be charged the full amount of the balance due. Without arranging payment, your child will be unable to attend further sessions.

Before you continue to payment...


1. Please note that we don't accept Israeli Amex / Diners credit cards.

2. Please do *not* use "Tashlumim" (Installments) if you are using an American credit card.

3. Please make sure that the address you enter matches the one listed on the credit card you use.