Number of children registered to come to Dor Haba:* A preferred method for calling and receiving important information* We are opening a WhatsApp group for parents and we would love for you to join it
E-mail Address* This address will be added to the conference mailing list, to which important information regarding the conference will be sent
Please note, sometimes the mail will go directly to the spam or advertisements box
Health details – to be filled out by a parent only! Additional emergency contact (if primary parent is unavailable)* to all your children
Full Name
Proximity to registrants
Telephone Number
Details of registrant #1*
Full Name
Israeli ID number (or passport #)
If so, should he/she be helped to do so?* Illnesses or Disabilities Please list and explain any illness or medical and/or dietary restriction, if any.
For example: diabetes, anemia, gluten allergy, celiac disease, lactose intolerance etc.
Does the child have a mental health diagnosis or a learning disability? For example: on the autistic spectrum, diagnosed attention deficit hyperactivity disorder, anger outbursts, depression or unstable mental state, etc. Please explain if he/she has certain needs and how we can help when they are having a difficult time
Details of registrant #2
Full Name
Israeli ID number (or passport #)
If so, should he/she be helped to do so? Illnesses or Disabilities Please list and explain any medical or dietary conditions, if applicable:
For example: diabetes, anemia, gluten sensitivity, celiac disease, lactose intolerance, etc.
Does the child have a mental health diagnosis or a learning disability? For example: on the autistic spectrum, diagnosed attention deficit hyperactivity disorder, anger outbursts, depression or unstable mental state, etc. Please explain if he/she has certain needs and how we can help when they are having a difficult time
Details of registrant #3
Full Name
Israeli ID number (or passport #)
If so, should he/she be helped to do so? Illnesses or Disabilities Please list and explain any medical or dietary conditions, if applicable:
For example: diabetes, anemia, gluten sensitivity, celiac disease, lactose intolerance, etc.
Does the child have a mental health diagnosis or a learning disability? For example: on the autistic spectrum, diagnosed attention deficit hyperactivity disorder, anger outbursts, depression or unstable mental state, etc. Please explain if he/she has certain needs and how we can help when they are having a difficult time
Details of registrant #4
Full Name
Israeli ID number (or passport #)
If so, should he/she be helped to do so? Illnesses or Disabilities Please list and explain any medical or dietary conditions, if applicable:
For example: diabetes, anemia, gluten sensitivity, celiac disease, lactose intolerance, etc.
Does the child have a mental health diagnosis or a learning disability? For example: on the autistic spectrum, diagnosed attention deficit hyperactivity disorder, anger outbursts, depression or unstable mental state, etc. Please explain if he/she has certain needs and how we can help when they are having a difficult time
Details of registrant #5
Full Name
Israeli ID number (or passport #)
If so, should he/she be helped to do so?* Illnesses or Disabilities Please list and explain any illness or medical and/or nutritional limitation, if any:
For example: low blood sugar, gluten sensitivity, celiac disease, lactose sensitivity, etc.
Does the child have a mental health diagnosis or a learning disability? For example: on the autistic spectrum, diagnosed attention deficit hyperactivity disorder, anger outbursts, depression or unstable mental state, etc. Please explain if he/she has certain needs and how we can help when they are having a difficult time
Regulations and rules of conduct at the conference Rules of Conduct* Please read the conference rules together with your child(ren).
Any participant who does not follow the rules will be called in for a conversation with two leaders.
If the behavior and attitude do not improve afterward, the participant will be called in for a meeting with the conference organizers.
If the behavior still does not change, the participant will be sent home — in coordination with the parents, at their expense, and without a refund of the conference registration fee.
Important: Violation of either of the first two rules will result in the participant being sent home immediately and without negotiation — in coordination with the parents, at their expense, and without a refund of the registration fee.
Confirmation registrant #1* I have read the rules and consequences, I understand them, and I agree to respect them
Confirmation registrant #2* I have read the rules and consequences, I understand them, and I agree to respect them
Confirmation of reading the rules to registrant #3* I have read the rules and consequences, I understand them, and I agree to respect them
Confirmation of reading the rules to registrant #4* I have read the rules and consequences, I understand them, and I agree to respect them
Confirmation of reading the rules to registrant #5* I have read the rules and consequences, I understand them, and I agree to respect them
Confirmation of reading the rules – parents* I have read the rules and consequences, discussed them with my son/daughter who is going to attend the conference, and I agree to arrange a homecoming if he/she is told he/she must leave the conference due to disrespectful actions or behavior as described in the consequences.
Special permits Permission to participate in the creative project* I authorize my child to appear in the music video with everyone at the conference and in other creative videos that may be produced during the conference that will be posted on Dor Haba’s Youtube channel
Parental permission Mother details* Or legal guardian
First Name
Last Name
Telephone Number
ID
Mother's approval* I give my permission for my son/daughter to participate in the “Dor Haba” conference, taking place at the ‘Nordia’ Guest House from July 14-17, 2025. I understand and agree that this is a Messianic conference under the spiritual covering of “Succat Hallel”, where they will be taught from Bible (Old and New Testament), and confess that Jesus is the Messiah and the Son of God.
Details of the father* Or legal guardian
First Name
Last Name
Telephone Number
Israeli ID number (or passport #)
Father's approval* I give permission for my son/daughter to participate in the “Dor Haba” conference, taking place at the Nordia Guest House from July 14-17, 2025. I understand and agree that this is a Messianic conference under the spiritual covering of “Succat Hallel”, where they will be taught from Bible (Old and New Testament), and confess that Jesus is the Messiah and the Son of God.
Registration for transportation Will your child/ren be joining the bus ride provided by Dor Haba?* 