Irish Language Easter Camp - Registration Form

Irish Language Easter Camp Registration

Tue 22nd - Thu 24th April 2025. Please note: A separate form needs to be completed for each child attending the Easter Camp.
CHILD INFORMATION:

Please complete a separate registration for form each child.
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Primary School class*

Primary 3Primary 4Primary 5Primary 6Primary 7
Name of School
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Does your child have any existing Irish language knowledge? (Prior knowledge is not necessary. We just want to get a sense of your child's experience).

NoneBasic words and phrasesConversational
Additional Emergency contact*

First NameLast Name
Relationship to child*
Phone Number for Additional Emergency contact *
Please enter a valid phone number.
MEDICAL INFORMATION
Does your child have any medical conditions or take any medication that we should know about?*

YesNo
If Yes please provide details below.
Does your child have any dietary requirements or allergies?*

YesNo
If Yes please provide details below.
Does your child have any access or disability needs?*

YesNo
If Yes please provide details below.
We will be taking photos at the Easter Camp to share news about the camp and to publicise the work of the Naiscoil. Images may be used in press releases, funding reports and published on our Facebook Page. Do you consent to photos of your child participating in the Easter Camp activities to be utilized as described above?

YesNo
My Products
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1st Child - Irish Language Easter Camp placeEnter description
£35.00 Quantity

Subsequent child/children - Irish Language Easter Camp place
£30.00 Quantity

Total

£0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Irish Language Easter Camp Registration

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION:

MEDICAL INFORMATION