Camp Dates A: July 22 - August 5 (2 weeks) B: July 22 - July 29 (1 week) C: July 29 - August 5 (1 week)
Family Name
Student's First Name
Gender Male Female
Date of Birth
Address
Postcode
Country
Email
First Name of Parent or Guardian
Family Name of Parent or Guardian
Home Telephone
Business Telephone
Mobile
Fax
Telephone Number during period of Camp if different from above
Nationality
Name of School/College
Mother Tongue
Second Language
Level of Judaism Orthodox Modern Orthodox Conservative Liberal Traditional
Do you wish to share with a friend's? Yes No
If yes, please give name of friend's
Does he/she have any allergies, special dietary requirements or medical Care: Yes No
If yes, please specify
Do you wish to study English? Yes No
Oral If yes, please mark the following - 1 Beginner, 5 Very Good 1 2 3 4 5
Written If yes, please mark the following - 1 Beginner, 5 Very Good 1 2 3 4 5
Do you require airport transfer to and from the camp?
From London Heathrow airport Yes No
From London Gatwick airport Yes No
From Ashford Eurostar Station Yes No
To London Heathrow airport Yes No
To London Gatwick airport Yes No
To Ashford Eurostar Station Yes No
London Eye ride (optional extra) Do you wish to take part? Yes No
Extra London Day Trip & Madame Tussauds Do you wish to take part? Yes No
Camp España Excursions Students aged 10 -14 will be accompanied on Excursions by monitors. Students over 15 will be allowed to walk around on their own or in a group for which I give my permission Yes No
How did you hear about Camp España? Friend Internet Relative School Newspaper Advertisement other 7
Travel & Insurance A certain level of Insurance is provided by the master Camp Beaumont policy. Please read the Terms & Conditions of that policy attached. If not adequate for your requirements you MUST take out additional insurance as we absolutely cannot be help responsible in the event of any unforeseen incident Please provide details of any additional insurance, which is compulsory, and must include travel, medical expenses, personal accident, cancellation & curtailment, baggage, personal property & money, travel delay and persona liability.
Accommodation, Full board, Kosher food, All Activities, Evening Programme and one Excusion each week. 1 week course: £549 2 week course: £998
English Language School (15 hours per week) 1 week course: £99 2 week course: £189 London Eye - £20 Extra London visit to include Madame Tussauds £45 Insurance To include Extreme Sports and Motor Sports - £38 per week Transfers London Airports collection: £69 Each Way London Eurostar collection: £69 Each Way Ashford Eurostar collection: £30 Each Way
By Cheque made payable to Camp Espana Yes No
or By Bank Transfer in Sterling Yes No
Bank: Natwest Bank PLC Address: PO Box 113, Cavell House, 2a Charing Cross Road, London WC2H 0PD Sort Code: 60-40-05 Account No: 32158033 IBANNo: GB77 NWBK 6040 0532 1580 33 BIC: NWBK GB 2L Account Name: Camp Espana NB: Please add £10 (sterling) to cheques and Bank Transfers to cover UK bank charges Conversion from sterling or dollars to euro will be at Natwest Bank buying rate on date of Bank conversion.
I confirm that I have read and agree to the terms and conditions Yes
I confirm that I have read and agree to the insurance policy Yes
DATES FOR SUMMER 2012 July 22 - August 5 (2 weeks) 1 week option available Ages 10 – 16 years