2020 Summer Camp Registration

Summer Camp 2020 Registration Form

These forms are required for your children to attend camp.
Camper's Information
Camper Name *
Nickname
Date of Birth *

Month Day Year
Age
NOTE - Children need to have completed Kindergarten or at least before they are eligible to participate in the summer camp.
Please upload your child's passport or Thai ID photo page

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Cancel of
Has your child enroled at panyaden in the past or participated previous years summer camp at Panyaden? *

Yes No
If yes, please explain what year and what class
(e.g. 2019 summer camp or 2018 Year 2)
T-Shirt Size *
Entering School Year in 2019/2020 *
Current School Name
(e.g. Phuket British International School)
Languages of instruction
(e.g. English 50% and Thai 50%)
School Location
(e.g. Bangkok/Thailand)
If your child is turning 6 years old after 1st of July 2020, to let us consider your application, please attached your child kindergarten full year school report.

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Cancel of
Camper english language proficiency at age related expectation

Beginner: Able to understand when listening to a short dialogue about an everyday situation Intermediate: Able to understand the main idea of conversation and common language functions (apologies, thank you) Fluent: Able to understand the conversation fully and high frequency vocabulary. Understand idioms and colloquial expressions Near Native/Native Level: Able to understand main idea or purpose or extended conversation that requires integrating or synthesizing information.
Camper Swimming Ability *

Non-Swimmer Beginner Swimmer (can swim on front 20ft without flotation) Advanced Swimmer
Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program.

Parents' Information

Parent/Guardian 1
Parent/Guardian 1 *

First Name Last Name
Relationship to Child *
E-mail *
Cell Phone *
Thai Phone Number only
English Language Proficiency

Beginner: Able,when listening to a short dialogue about an everyday situation Intermediate: Able to understand the main idea of conversation. Understand common language functions (apologies, thank you) Fluent: Able to understand the conversation fully, understand high frequency vocabulary. Understand idioms and colloquial expressions Near Native/Native Level: Able to understand main idea or purpose or extended conversation that requires integrating or synthesizing information.
Parent/Guardian 2

First Name Last Name
Relationship to Child
E-mail
example@example.com
Cell Phone
English Language Proficiency

Beginner: Able,when listening to a short dialogue about an everyday situation Intermediate: Able to understand the main idea of conversation. Understand common language functions (apologies, thank you) Fluent: Able to understand the conversation fully, understand high frequency vocabulary. Understand idioms and colloquial expressions Near Native/Native Level: Able to understand main idea or purpose or extended conversation that requires integrating or synthesizing information.

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age.
Emergency Contact

Emergency Contact #1
Full Name *

First Name Last Name
Primary Phone Number *
Relationship to Child *
Emergency Contact

Emergency Contact #2
Full Name

First Name Last Name
Primary Phone Number
Relationship to Child

Payment and Statement of Understanding
Panyaden has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported. *
Type first and last name above to consent
Sign Document *
Date Signed *

Month Day Year
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Summer Camp 2020 Registration Form

Camper's Information

Parents' Information

Emergency Contacts/Authorized Pickup

Emergency Contact

Emergency Contact

Medical / Health Information

Payment and Statement of Understanding