InterAction Belgium B: 6-12 August 2018
If you have any questions, please email inscriptionsbelgique@interactioncamps.org
Camper's Information
Surname *
Your answer
First name *
Your answer
Middle names
Your answer
Gender *
Address *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Language of Preference (mother tongue) *
Required
Would you like to travel with the InterAction Travel Party?
How did you hear about InterAction? *
Your answer
Dietary requirements *
Your answer
Parent/ Guardian
Surname *
Your answer
First name *
Your answer
Email Address *
Your answer
Mobile phone number *
Your answer
Address *
Your answer
I give permission *
for my child to receive emergency medical attention, to travel in InterAction vehicles where necessary, to swim in accordance with the regulations in force for collective holiday centres
I authorise InterAction and La Ligue *
to use photos, slides or videos in which my child may appear, for the purposes of promoting future Camps and activities, whether in leaflets, brochures, videos or website. I authorise LLB to circulate my child’s address to other participants of the camp
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms