Open Opportunity Service Summer Camp 2025 Registration Form

Open Opportunity Service Summer Camp 2025 Registration Form

For any queries, please contact Aisling: aniceochaidh@sbhi.ie or 087 119 0100. Please note: The team will contact you to confirm whether you have been allocated a place on the camp.
Parent/Guardian Details
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Details
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Please state whether this child has any allergies, medical conditions, or specific requirements:
Please state your child's interests, hobbies and likes:
Emergency Contact Details
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Relationship to child:*
Media Consent

Spina Bifida Hydrocephalus Ireland (SBHI) hosts many events for our service users and members, some of which you or your family may attend. During these events SBHI may take photographs, video recordings or audio recording/quoted remarks which include service users/members, their families, volunteers and staff. From time to time, these forms of media are used by Spina Bifida Hydrocephalus Ireland for printed publications/materials, electronic publications or presentations, the SBHI website, or other SBHI social media platforms (Facebook, Twitter, Instagram, or similar). In compliance with General Data Protection Regulation (GDPR) SBHI is obliged to ask you to sign a consent form for your prior approval.
Please tick your preference and sign below:*

YES - I hereby GIVE permission to Spina Bifida Hydrocephalus Ireland to use photos/recordings which may include me, and/or my child and/or my family at various events within the Association for promotional material or public information.NO - I DO NOT GIVE permission to Spina Bifida Hydrocephalus Ireland to use photos/recordings which may include me, my child and/or my family at various events within the Association for promotional material or public information.
Should be Empty:

Open Opportunity Service Summer Camp 2025 Registration Form

Parent/Guardian Details

Child Details

Emergency Contact Details