Enrollment form (Contract)

Participant’s personal data

Name *

Surname *

Your sex *

Date of birth *

Address (street and number of place) *

City *

Postcode *

E-mail *

Phone number *

Name and address of the school *

Information regarding the camp

Type of the camp *

Place of the camp *

Language *

Dates *

I want to book optional fitness lessons (Dźwirzyno or Jastrzębia Góra) *

I want to book optional tennis lessons (Dźwirzyno) *

I want to book windsurfing lessons (Dźwirzyno) *

I want to book climbing lessons (Zakopane) *

I want to book optional Beauty Parlour - workshop (Jastrzębia Góra) *

I want to book Krav Maga lessons (Jastrzębia Góra) *

I want to take part in optional trip: *

Transfer *

Language level *

Where and how long have you been learning the language? *

Which books did you use to learn the language? *

How did you find out about our camps? *

Have you ever taken part in LEKTOR’s camps? When? *

Information regarding participant’s health

PESEL number *

Please enumerate chronic illnesses participant suffers from (including allergies) and the medicaments participant takes: *

What types of food and medicaments (including antibiotics) is participant allergic to? *

Was the child vaccinated against (if yes please provide the dates):

tetanus *

diphtheria *

typhoid *

other (which ones?): *

Other remarks regarding participant’s health (How does the child bear car ride? Does he/she wear glasses or braces?) : *

The agreement is made between Lektor Travel sp. z o.o. Oławska 25, Wroclaw and

Name and surname of parent or legal guardian *

Address *

Parent/legal guard’s phone number valid for the time of the camp *

I am decided to take part in a camp four youth/camp for children. I oblige myself to pay for the camp within 5 days after receiving the confirmation of reservation and to send completed application form and test.

Terms of participation in a camp

I accept the terms & conditions

Akceptacja regulaminu *

I declare that have familiarized myself with the framework programme and these terms and conditions which constitute an integral part of the contract concerning participation of my child in the camp in:

Place *

on *

and I declare my full acceptance of these terms and conditions by affixing my signature herein. I also declare that I have provided, to the best of my knowledge, all important information concerning my child’s health that is needed in order to ensure appropriate care for my child during the camp.

City

City *

Date

Date *

Signed application form need to be printed and sent to LEKTOR.

Popularne obozy w Polsce

Dokumenty i rezerwacja

Popularne kursy zagraniczne