Campette Signup 2015

Step 1 of 4

All about the Campette

Campette's Forename:*

Campette's Surname:*

Campette's Date of Birth:*

*Please note: Campette must be ages 11,12 or 13 at 1st July 2015 to attend this camp. Proof of age may be requested at Camp.

Campette's age at 1st July 2015:*

* Campettes age at 1st July 2015.

Summer camp of choice:*

Jersey sizes:*

* Please note: these are O'Neill's sportswear sizes. We will do our best to give Campettes their preferred jersey size, or that closest to it. However, this is not guaranteed.

Has your daughter been to Camp before? *

If so, please select which Camp:

Please state the name of ONE other Campette you would like to be in your Campette's group at Camp?

* Please note it is not always possible for us to place friends together.

Step 2 of 4

All about the Parent / Guardian

Parent/Guardian's Forename:*

Parent/Guardian's Surname:*

Address:*

Town/City:*

Parent/Guardian's Postcode (if ROI put N/A):*

Parent/Guardian's County*:

Parent/Guardian's Contact number:*

Parent/Guardian's Mobile number:*

Confirm Parent/Guardian's E-mail Address:*

Please note: Please take care when submitting your e-mail address as this will be used as a primary point of contact.

Name of person responsible for the Campette in the event of the parent / guardian being unavailable:* 

Relationship with child:* 

Responsible Adult contact number:*

* = Required field

Step 3 of 4

Campette's Medical Conditions / Emergency Contact Details

Does your Campette have any allergies? *

If so, please state what:

Does your Campette use regular medication? *

If so, please state what:

I grant my consent for Michaela Foundation to seek medical care for my Campette in case of an emergency:  *

Is there anything else you wish to tell us about your Campette’s health and/or wellbeing? :

* = Required field

Step 4 of 4

Photography Consent

Michaela Foundation's Imaging Policy and Guidelines

Campette's level of Irish language: *

Where did you hear about Camp? (Only select one):*
FacebookTwitterMichaela Foundation WebsiteSchoolRadioChurchCommunity ClubNewspaperFriend / FamilyMichaela Foundation Team Member / VolunteerOther

If other, please state where :

* = Required field

To be completed by the Campette and their Parent / Guardian

Do you and your Campette agree with and accept Michaela Foundation’s Code of Conducts for parents/guardians and Campette’s?