Summer Camp 2019 Online Application Form

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Please fill in this form to apply for a child placement on our Summer Camp, click the 'Submit' button when completed to send in your form and we will contact you asap to confirm your child's place. Use one form per child place requested.

Name and Surname of Child *

Name of Parent(s)/Guardian(s) *

Email Address *

Home Address *

Phone Number *

Child's Date of Birth *

YYYY

Child's Age (at present) *

A) Alternative Contact Name in case of Emergency *

B) Phone number of emergency contact as named above *

Name of anyone other than yourself who is permitted to collect your child

Please list any medical conditions or allergies that your child suffers from:

Any other information you feel we should be aware of:

I give permission for my child as named above to be photographed/videographed at summer camp in a solo or group capacity for the purpose of sharing on social media, placing on school website and storing at BAPA offices. *

YES

Required

Submit

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