CLÉIRE LASMUIGH
Cape Clear Island / Oileán Chléire
West Cork / Iarthar Chorcaí
grupai@lasmuigh.ie
https://lasmuigh.ie
085 2029094
Cléire Lasmuigh - Foirm Clárucháin
Registration Form 2024
GRÚPAÍ / SCOILEANNA 2024
GROUPS / SCHOOLS 2024
Ainm & Seoladh Scoile nó Grúpa / Group or School Name & Address
Address1
Address2
City
State / Province
Ainm Teagmhála / Contact Name
*
Ainm / Name
Sloinne / Surname
REF
Reference on quotation if applicable.
Ríomhphost / Email
*
Ríomhphost / Email
Guthán / Phone
*
Guthán / Phone
Saghas Ghrúpa / Group Type
*
Teaghlach / Family
Scoil / School
Gnó / Corporate
Gaisce / Youth Group
Dátaí / Date of Visit
*
Eachtraí / Activities
*
Currachóireacht / Kayaking
Snámh Fé Thoinn / Snorkelling
Seascéaslóireacht / Paddleboarding
Turas Feirme / Farm Visit
Dúshláin Foirne / Team Challenges
Síulóid / Walk
Méid / Number in group
*
Eolas Leighis / Medical Info
Please enter here any medical information we should be aware of - or let us know before activities start. All information is kept confidential and only for the period of the visit.
Payment
Gaisce Group
Full Payment
50% Deposit
Iomlán / Total
Earlais / Deposit
Íocaíocht / Payment - please enter either Total or Deposit as above.
*
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Description
Please verify that you are human
*
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Priontáil / Print Form
Seol / Submit
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