Activ8 Summer Camp Newbridge Registration Form 2022

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Please fill in one form per child attending summer camp. After submitting details successfully please proceed to payment to secure your child's place.

Email *

Camp 2022 Details

We are delighted that Activ8 Newbridge Summer Camp is back for summer 2022 and is running at Gaelscoil Chill Dara, Newbridge for 4 weeks from 8.30am-4.30pm each day.
The cost per child per week is €80 with child 2 upwards being €72 (10% discount)

Week 1- July 4th-8th
Week 2-July 11th-15th
Week 3-July 18th-22nd
Week 4- July 25th-29th

Pfizer Parents/Guardians can sign their children up for as many weeks as they like!

This year our Adveneture Day Trips will be on every Wednesday of Camp!

We feel that the children and their hard working parents.guardians need and deserve it this year, more than ever before. We are committed to making it a very special, fun and safe camp for all involved.

We look forward to see you all soon.

Child's Name and Surname (one child per form) *

Pfizer Employee Name (Main camp contact): *

Pfizer Employee Number: *

Child's age (on 4th July 2022) *

Tick the weeks your child is attending Summer Camp. (There is no cap on weeks this year as extra space available in base school if needed) *

Week 1 (Monday 4th July- Friday 8th July)

Week 2 (Monday 11th-Friday 15th July)

Week 3 (Monday 18th -Friday 22nd July)

Week 4 (Monday 25th-Friday 29th July)

Required

Parent/ Guardian (Employee and main contact) Email address: *

Main Contact phone number *

Secondary contact Name: *

Secondary contact Number: *

Secondary contact relationship to child: *

Does your child have have access to a Special Needs Assistant (SNA) in school ? *

Yes

If your child has SNA access at school or any additional needs, please give us more details so that we can best support them on Camp:

Allergies: *

Name of Sibling(s) on the camp

Any other important information we should know:

Authorised Pick up:

Please include details for any authorised pick up other than parent/ guardian

Name:

Phone number:

Relationship to child

Medical Form:

It is our aim to cater for all children. In order for us to do this, and in the best interest of each child, we require parents to give us details in advance, of any additional needs or special requirements that their child may have.

Please tick if any of the following apply to your child: *

Tick if your child currently under a physician’s care

Tick if your child suffers from asthma

Tick if your child is suffering from Diabetes

Tick if your child is currently taking medication

Tick if there is any medical, physical or psychological conditions of which camp staff should be aware of?

Tick if NO to all of the above

Required

If you ticked any of the medical conditions above. Please give more information.

If you have any concern about an underlying medical condition of your child in the light of Covid-19, please seek the advice of a medical professional.

I understand that I am responsible to discuss any concerns about an underlying medical condition with my doctor before sending my child to Activ8 Camp *

Yes

Not relevant (my child has no underlying condition relevant to Covid-19)

Family Doctor Name: *

Family Doctor Phone Number: *

Photo/ video consent. Permission to be photographed/ video recorded while in attendance at Grange Castle Activ8 Camp. Media files may appear on Class Dojo for daily parental communications, the roundup weekly parental online newsletter, on www.activ8camp.com or on Pfizer's internal on-site media to promote future camps. *

Yes

Accident & Emergency Consent Form: I give permission to the personnel of the Activ8 Camp managed Pfizer camp to act on my behalf in case of emergency or accident and to take such action as may be necessary for the benefit of my child. This decision is to be taken by the designated person in charge at the time of the emergency. *

Yes

Please note you must fill out one form per child attending. After submitting the details successfully please continue to payment to confirm your place. Please remember to add the Stripe handling fee of €5 if paying by card payment option.Thank you.

A copy of your responses will be emailed to the address you provided.

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