Burren Coding and Adventure Camp Registration Form
July 25-29 2016
Instructions
Booking a place for ONE vistitor at the Burren Code Camp 2016. Please use a new form for each visitor.
For any questions about filling out this form call us:
phone: +353 87 913 2941
email: steve@creativecomputerlab.com
Upon submission of the filled-out form, we will contact you with price and payment information by email.
First name(s) of visitor *
Your answer
Last name of visitor *
Your answer
Date of birth of visitor *
MM
/
DD
/
YYYY
Gender of visitor *
Contact detail of parent / guardian: first name and last name *
Your answer
Contact detail of parent / guardian: address *
Your answer
Contact detail of parent / guardian: email. Note: enter phone number if you have no email *
Your answer
Contact detail of parent / guardian: phone number(s), including international country code. *
Your answer
Day visit or sleepover ? *
Estimated Arrival Date and Time *
Only if pickup from Dublin International Airport is requested: Date, Time and Flight Number of flight to Dublin
Your answer
Estimated Date and time of Departing *
Only if transport for flight home from Dublin International Airport is requested: Date, Time and Flight Number of flight from Dublin
Your answer
Any Special Dietary Requirements?
Your answer
Any medical conditions the staff should be aware of?
Your answer
If you wish to be grouped with friends / silblings please list names:
Your answer
I have bought for the visitor travel insurance vovering medical cost and transport to hospital *
Visitor coding experience:
Your answer
Visitor will bring this device for coding *
Additional request / remark / notification
Your answer
The Burren Summer Camp come to my attention by:
I, the guardian, understand that my child may appear in photographs and videos made in the camp for documentary and promotional meanings *
Required
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