BOOK NOW – Summer 2017

To enrol your child for this year’s summer camp, please complete the registration form below:

About Your Child

Which camp will your child be attending? - Please choose north (Cockermouth) or south (Coniston)
Name Date of birth
Age of child when at camp Gender

Your Child's Medical Information

Does your child have any of the following medical conditions?

 Asthma Heart Problems Seizures Hayfever Allergies ADHD Diabetes Epilepsy Autism (ASD) Physical Disability Any Fears/Phobias

ALL MEDICATION SHOULD BE SUPPLIED BY THE PARENT / GUARDIAN AND ADMINISTERED BY YOURSELF OR THE CHILD.
ANY MEDICATION SHOULD BE PLACED IN WATERPROOF PACKAGING TO ENSURE IT IS NOT DAMAGED OR AFFECTED WHILST ON THE CAMP.
CAMP CUMBRIA WILL TAKE NO RESPONSIBILITY FOR THE SUPPLY OR ADMINISTRATION OF MEDICATION, WHICH ALSO INCLUDES SUNSCREEN.

Parent / Guardian Personal Information

Name
Address
Home telephone
Work telephone
Mobile telephone
E-mail address
Secondary contact person
Relationship to child
Home telephone
Mobile telephone
Who will be dropping off / collecting your child from CAMP Cumbria?

Recommendations

How did you hear about us?
If you were recommended by someone, please let us know who:

Camp Booking Details

Camp Weeks

Week 1

31st July – 4th August

 Whole Week Monday Tuesday Wednesday Thursday Friday
If you wish to book your child for specific days, please select which individual days you would like to book.

Week 2

7th – 11th August

 Whole Week Monday Tuesday Wednesday Thursday Friday
If you wish to book your child for specific days, please select which individual days you would like to book.

Week 3

14th – 18th August

 Whole Week Monday Tuesday Wednesday Thursday Friday
If you wish to book your child for specific days, please select which individual days you would like to book.

Week 4

21st – 25th August

 Whole Week Monday Tuesday Wednesday Thursday Friday
If you wish to book your child for specific days, please select which individual days you would like to book.

Transport

Will your child require transport?  Yes No
If yes, where are we picking your child up from?
If yes, where are we dropping your child off?

Packed Lunch

Will your child require a packed lunch?  Yes No
Does your child have any allergies / dietary requirements?  Yes No
If yes, please provide the details below:

Camp Cumbria Policies

CANCELATION POLICY



If you cancel your booking less than 4 weeks prior to the start of the camp, there will be no refund given.

All cancelations must be made in writing to CAMP Cumbria.

PHOTOGRAPH POLICY



Activity photos are often taken at CAMP Cumbria and are used solely for the purpose of marketing for our camp.

Please select if you DO NOT want your child to be in any photographs.

CAMP AUTHORISATION



 I consent to my child participating in all activities involved in the programme, some of which may be water based.
 I approve of the above application form and in doing so, agree that CAMP Cumbria, its Directors, Leaders, Staff and Instructors shall be released from and not incur any responsibility or liability for any accident or injury to the applicant or for any damage to or loss of the property of the chid.
 I agree to the booking terms and conditions for CAMP Cumbria.
 I can confirm that all information supplied is correct and any changes to the above application are to be notified to CAMP Cumbria at the earliest opportunity.

Alternatively, If you’d like to download the form and fill it in offline, you can download it here:

DOWNLOAD REGISTRATION FORM