Summer Camp Detailed Registration Form

Summer Day Camp Registration 2021

Please complete the form below
Information
Student Name *

First Name Last Name
Birth Date *

Month Day Year
Age *
Is your child Exupery International School student? *

Yes No
Native language *

Latvian Russian Lithuanian Estonian English French Hebrew
Gender *

Male Female
What period are you interested in? (one or more) *

05-16/07/2021 (for 8-17 y.o.) - Future Tech & Dreams 19-30/07/2021 (for 8-17 y.o.) - Space & Earth Passion 05-23/07/2021 (for 4-7 y.o.) - Language, Art & Science 05-16/07/2021 (for 4-7 y.o.) - Language, Art & Science 12-23/07/2021 (for 4-7 y.o.) - Language, Art & Science
Level of English *

Beginner Elementary Pre-intermediate Low Intermediate Intermediate Upper Intermediate Pre-advanced Advanced Very Advanced
Check the table below to see which level you have
WhatsApp number (optional)

Area Code Phone Number
Do you have any special needs, diets or conditions? If yes, please describe.
Parent/Guardian Information
Name *

First Name Last Name
Phone Number *

Area Code Phone Number
WhatsApp Number (optionally)

Area Code Phone Number
E-mail *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Emergency Information
Emergency Contact's Name *

First Name Last Name
Relationship *
Local Phone Number *

Area Code Phone Number
Alt. Phone Number *

Area Code Phone Number
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the student prescribed an inhaler? If yes, please explain any instructions.
Please, enter the discount coupon code
Questions and comments
Questions? Please ask us here
I agree to the processing my personal data in accordance with the information provided herein

I agree
This information will be used to process your order throughout the website exupery.lv, will be held and processed by us in the Republic of Latvia under the law of the Republic of Latvia and will be handled according to applicable EU data protection rules. We collect: 1. PII information that identifies you – Personally Identifiable Information (name, surname, email address and phone number); 2. NON-PII information that does not identify you – Non-Personally Identifiable Information (IP address or type of browser).
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Summer Day Camp Registration 2021

Questions and comments