World Abilitysport  Adult recreation camp application form
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Please read the Adult Camp Information pack before completing this application form. 

Please complete the application form to apply to the adult camp - we cannot wait to hear from you.
Family Name *
Participants  Name *
Date Of Birth *
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Country of Residence *
Postcode *
Contact email address  *
Contact Phone number  *
Do you require a PA to attend the camp with you?  *
Name  of Next of Kim  or PA/carer attending *
Next of Kin email address  *
Next of kin Phone Number *
 Have you attended a CPISRA / IWAS  Recreation Camp before?    
 *
If Yes please state the year(s):

Please explain your disability including the level of mobility and any learning needs? (Please include any aids you use to move around or walk)   150-200 Words

*
Please tell why you  would benefit from taking part in the Adult  Recreation Teen Camp  (200-300 Words) 
 *

What do you hope to gain from attending the adult  Recreation Camp to help you live life to the full?  (150-200 words) 

 *
If you require the support of more than one / carer please tick the box and someone from the CPISRA/IWAS  team will be in touch to discuss your needs to ensure we are able to accommodate them. 
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Please state the size of camp t-shirt you require (all t-shirts will be adult sizes) 

 *

Please state the size of the camp t-shirt for the PA /carer if required  (all t-shirts will be adult sizes): 

 *
Please tick the box to confirm that you have read the information pack and agree to the terms and conditions of the camp.  *
Required
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