Backpackers Registration
Please complete this form once per child
Email address *
Name of child *
Your answer
Gender of child *
Date of birth *
MM
/
DD
/
YYYY
Address *
Your answer
School
Your answer
Name of parent / carer *
Your answer
Parent / Carer's email *
Your answer
Parent / carer's phone number *
Your answer
Emergency contact name (if not parent/carer)
Your answer
Emergency contact number
Your answer
Any medical / special needs
Your answer
My child would like to be in the same group as:
Your answer
Photo permission
I understand that I will have to pay £5 upon arrival *
Required
A copy of your responses will be emailed to the address you provided.
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