The Bilingual Connection Camp Booking Form

Child's First Name:

Child's Last Name:

Halloween or Spring Camp: Halloween CampSpring camp

School Name:

Class Group: CE1CE2CM1CM26eme5eme4eme3eme

Child's Date of Birth (DD/MM/YY):

Sex: MaleFemale

1st Pref Mobile:

2nd Pref Mobile:

Home Address:

English Level (please give details):

Email:

Please note names of friends travelling on trip you would like to share with:

Important: Does your child suffer from any health issues such as asthma, epilepsy? (Please mention also if they wear glasses or any devices such as hearing aids, or are currently taking medication.)

Does your child suffer from any particular food allergies or does your child refuse to eat any particular foods that we should be aware of?

Does your child suffer from travel sickness?

Can your child swim confidently? (for all water activities children will be wearing life jackets)

Does your child have any difficulty sleeping or suffer from sleep walking?

Does your child have any particular phobias such as fear of spiders, of heights?

Has your child travelled independently before (in a school group, with a sports club etc) please give details:

In the case of any emergency and in case the school is unable to contact you, can you please provide an alternative person to contact other than a parent:

Name:

Number:

Relation:

I agree that a staff member of The Bilingual Connection may administer paracetemol to my child for a headache if necessary (or a similar equivalent.....if you have a preference please specify):



I agree that a member of the Bilingual Connection may take my child to a G.P. in the area if they are sick

I agree that a member of the Bilingual Connection may bring my child to the hospital for emergency care in the case of an accident or injury (a member of the Bilingual Connection staff would be present at all times and parents would be updated throughout the process)

I agree that the above information is correct and attest that I have “Responsabilite Civile” insurance for my child's participation in extra curricular activities.

Policy No:

Company::

I have an European Health Insurance Card for my child which covers costs of medical care abroad (these are free and are available from ameli.fr)


Please provide this card at the time of travel

I agree to reimburse the Bilingual Connection for any medical costs incurred while abroad (Doctors fees etc)

I am aware that deposits (€207.20 per child including booking fee) are non refundable

If there is any other information regarding your child that you feel would be useful for the staff to be aware of, please let us know:

Parent's Name:

Date:

I have read, and agree to, the company’s “Terms and Conditions” and am aware this can be viewed at any time on the school website