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Foirm iarratais Champa Chaitríona: 5 - 9 Iúil 2021. Campa Chaitríona Application Form: 5 - 9 July 2021.
Is do dhaltaí a bheidh ag tosach i mBliain 8 i gColáiste Chaitríona Meán Fómhair amháin an campa seo.
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Email
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Your email
Ainm an pháiste: Name of child:
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Your answer
Dáta breithe: Date of birth:
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MM
/
DD
/
YYYY
Seoladh: Address:
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Your answer
Bunscoil:
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Your answer
Uimhir theagmhála Tuismitheora/Caomhnóra: Parental/Guardian contact number:
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Your answer
Rphost Tuismitheora/Chaomhnóra: Parental/Guardian email address:
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Your answer
Ainm duine amháin ar mhaith leat do pháiste bheith in aonghrúpa leis: Name of one friend your child would like to be in the same group with:
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Your answer
Tabhair eolas faoi ailléirge ar bith atá ag do pháiste: Any information about allergies your child has:
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Your answer
Tabhair eolas faoi leigheas ar bith a ghlacadh do pháiste: Any medical information relating to your child:
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Your answer
Teagmháil éigeandála 1: Emergency contact 1:
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Your answer
Teagmháil éigeandála 2: Emergency contact 2:
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Your answer
Tugaim cead grianghraif de mo pháiste a ghlacadh agus a úsáid ar na meáin shóisialta/I give permission for photographs to be taken of my child and used on social media:
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Tugaim/Yes
Ní thugaim/No
Tugaim cead cóir leighis a thabhairt do mo pháiste ag garchabhróirí/dochtúirí/paraimhíochaineoirí srl/I give permission for my child to receive medical tretment from First-Aiders/doctors/paramedics:
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Tugaim/Yes
Ní thugaim/No
Ag deireadh an lae/At the end of the day:
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Tógfaidh mise mo pháiste/I will collect my child
Tógfaidh duine fásta ainmnithe mo pháiste/A nominated adult will collect my child
Siúlfaidh mo pháiste abhaile/My child will walk home
Rachaidh mo pháiste abhaile ar an bhus curtha ar fáil ag Coláiste Chaitríona/My child will go home on transport provided by Coláiste Chaitríona
Má thógfar do pháiste ag duine fásta ainmnithe, tabhair an t-ainm agus an uimhir theagmhála thíos. If your child is to be collected by a nominated adult, please provide their name and contact number:
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Your answer
Má tá sé ar intinn agat do pháiste a chur ar an bhus atá ar fáil ag Coláiste Chaitríona, cuir in iúl cá háit a dtógfar/mbaileofar é. If you intend to avail of transport provided by Coláiste Chaitríona please indicate where they will be picked up /collected.
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Your answer
Eolas cuí ar bith eile/Any other relevant information:
Your answer
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