Inscription EIC Summer Camp 2015

Family Information
Tutor 1 (Name and
surnames)
Tutor 2 (Name and
surnames)
Address;
Town
Post Code
email address
Telephone numbers in case of having to contact childrens family written in order according to necessity.
Ord.
Name
Relation to pupil
Telephone
Observations
1
2
3

Information Pupil 1
Nam
e:
Date of birth:

Surname
1

Course attended in 14/15 school

year

School attended 13/14

Care service?
( 8h-9h 10/Week)

Weeks

July activity:

Surname 2

Yes
NO

Is pupil registered for EIC 15/16

school year?
Is pupil staying for lunch?
Parents who collect children before lunch at 13:00 25/week will
be discounted. This request must be made on inscription and will
not be valid after.

29 June-3
July

Camp

School
September
Information Pupil 2
Nam
e:
Date of birth:
School attended 13/14

Surname
1

Care service?

Yes

( 8h-9h 10/Week)

Weeks

July activity:

Timetabl
e:

NO

NO

2024
July

2731
July

9-13

9-15

9-17

School

Surname 2
Course attended in 14/15
Is pupil registered for EIC 15/16
school year?
Is pupil staying for lunch?

Yes
NO

Parents who collect children before lunch at 13:00 25/week will

be discounted. This request must be made on inscription and will
not be valid after.

NO

29 June-3
July

Camp

6 10
July
Timetabl
e:

Yes

1317
July

2024
July

2731
July

9-13

9-15

9-17

Camp
Surname
1

YES

1317
July

Camp

School
September
Information Pupil 3
Nam
e:
Date of birth:

6 10
July

Yes
NO

School

Surname 2
Course attended in 14/15

ESCOLA INTERNACIONAL DEL CAMP-SALOU- Carrer Salvador Espriu, s/n 43840 Salou
Apartat de correus 263 Telfon 977 325 620 serveis@escolainternacional.org

School attended 13/14

Care service?
( 8h-9h 10/week)

Weeks

July Activity

School

Yes
NO

Is pupil registered for EIC 15/16

school year?
Is pupil staying for lunch?
Parents who collect children before lunch at 13:00 25/week will
be discounted. This request must be made on inscription and will
not be valid after.

29 June-3
July

Camp

6 10
July
Timetabl
e:

September
Important: Documentation to be attached;

Yes
NO

NO
Yes

1317
July

2024
July

2731
July

9-13

9-15

9-17

Camp

School

Photocopy of NIC of authorised tutor.

Photocopy of Medical Card
Photo of participating child.

ESCOLA INTERNACIONAL DEL CAMP-SALOU- Carrer Salvador Espriu, s/n 43840 Salou
Apartat de correus 263 Telfon 977 325 620 serveis@escolainternacional.org

Tutor Authorization

(One per participant)

Mr./Mrs._________________________________________(Full ame) Identity n__________________

As ____________________ (relation to participant) hereby authorize________________________
(name of participant)

to attend the activities organized by ESCOLA INTERNACIONAL DEL CAMP within the
programmes of EIC SUMMER CAMP which will take place from 29th July to 10th
September of the current year and certify with my signature the authenticity of all data
which is written on this document, also extending with this authorization for the specifics
that are detailed herein including travel, medical, image and data protection. s).
With the completion of this form I hereby authorize specifically that the data contained
on this form as well as all documentation included may be dealt with and incorporated
in a file which is the responsibility of Foundation Escola Internacional del Camp, CIF G43731256 also Lescola Internacional del Camp with registration number CIF
B555433831 confirms that which is included in articles 15 and 16 of the Law llei
Organica 15/1999 of 13 de December of Personal data protection . Please be informed
that you can exercise your right of access , rectification , cancellation or opposition to the
school at Salvador Espriu s/n, 43840 Salou (Tarragona)
Medical Information
Does the child suffer from any chronic
illness?
Could it affect their daily activities
Does the child need to take any
medication?
Times and Dose of medication with
doctors prescription
Any food intolerance?
Any dietary recommendation?
Other remarks especially allergies.

Other Information
Can your child swim ?

Yes

NO

Authorization
I hereby authorize that my child can carry out excursions, trips programmed in the activity
programme as well as any journeys in a school car that may be required for the child or doctor
etc..
I authorize that the data and protocol of my parental responsibility will be accessible

I authorize that medical decisions that should be required to be taken in case of extreme
emergency be taken by the faculty management.

Authorize that EIC, ESCOLA INTERNACIONAL DEL CAMP may use graphic material such as photos
or videos coming from activities carried out by my child during the various PROGRAMMES EIC
SUMMER DE 2015

NO
Yes
NO
YES
NO
Yes
NO
YES

Salou, _________Date__________________________ 2015

ESCOLA INTERNACIONAL DEL CAMP-SALOU- Carrer Salvador Espriu, s/n 43840 Salou
Apartat de correus 263 Telfon 977 325 620 serveis@escolainternacional.org

Signature Parent of Guardian.

ESCOLA INTERNACIONAL DEL CAMP-SALOU- Carrer Salvador Espriu, s/n 43840 Salou
Apartat de correus 263 Telfon 977 325 620 serveis@escolainternacional.org