Adventure Summer Camp 2015
Childs Information
Childs Full Name:
Address:
_______________________
_______________________
Parent/Guardians Name:
_______________________
_______________________
_______________________
Age: ____
Gender: ____________________
Date Of Birth: ___________
Emergency contact Information
Full Name: ________________________
Full Name: _________________________
Relationship to Child: ________________
Relationship to Child: _________________
Phone number: _____________________
Phone Number:
____________________
Summer Camp Dates
Castlebellingham
Newgrange Lodge Donore
Week 1: 6th July – 10th July
Week 3: 20th July – 24th July
Week 2: 13th July – 17th July
Week 4: 27th July – 31st July
Castlebellingham Camp Fee is €100 per child.
Deposit:
€_______
Newgrange Lodge Camp fee is €120 per child.
Balance Due
€ ______
€40 deposit payable on application (nonrefundable /non-transferable)
Paid in Full
€_______
Balance to be paid by the 30th June 2015(Balance can be paid in instalments).
Checklist
Have you read and signed the Camp’s information Sheet?
⃝
Have you completed and signed the medical form?
⃝
Parents/Guardians Signature:
____________________________________
Forms to be posted to: Celtic Adventures, Ballynagrena, Dunleer, Co. Louth
Contact: 0416863637
www.celticadventures.ie
Email: info@celticadventures.ie
Celtic Adventures Summer Camp 2015 Camp Information and Booking Conditions
Payment is regarded as acceptance of the booking conditions.
Any participant whose conduct is deemed by the Camp Staff to be detrimental to the best interest of
the camp will be dismissed – no refund will be made.
Cancellations are subject to forfeiture of the booking deposit of €40 per child
The camp will operate to the highest safety standards; we shall not be responsible for any illness or
accident unless occasioned by the proven negligence on the part of the camp Director or employees.
Celtic Canoes Summer camp accepts no responsibility for items lost or stolen.
The camp reserves the right to change , modify or omit any activity in the event of unforeseen
circumstances.
Places are allocated on a first come first served basis.
Permission is granted to seek medical treatment in the event of an accident and a medical
information sheet must be completed for each child.
Children need to be signed in an out each day by either a parent/guardian or an adult nominated
by parent or guardian.
Summer Camp staff cannot administer Medication
Water Activities
I understand that the Celtic Adventures Summer Camps include activities in and near water and will
include canoeing and raft building. I give permission for my child to participate in all water activities
included in the camp.
CHILDREN WILL BE WEARING BUOYANY AIDS AT ALL TIMES WHEN PARTICIPATING IN WATER
BASED ACTIVITIES.
Buoyancy Aids are provided by Celtic Adventures.
Photo Release
I hereby give permission for my child’s photo to be taken and permission for its possible use on the
Celtic Adventures website.
I have read and agree to the above conditions.
Signed _________________________Parent / guardian of ______________________(Childs Name)
CHILDREN MUST HAVE THEIR OWN WETSUIT FOR WATER ACTIVITIES
Adventures Summer Camp
Medical information
Childs Name: _______________________________________________
Date of birth: ______________________
Doctor’s name: ______________________
Please list any known Medical conditions he/she may suffer from ( asthma, diabetes etc)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
List of current medications:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Any allergies he/she may have:
__________________________________________________________________________________
__________________________________________________________________________________
I give my consent for my son/ daughter to receive medical treatment should any emergency occur.
Signed __________________________________________ (parent/ guardian).