REGISTRATION : Family InformationParent /Tutor 1 (Name and surnames) DNI/NIE/PASSPORTParent /Tutor 2 (Name and surnames) DNI/NIE/PASSPORTInvoicing details:E-mail AddressTown Post CodeAddress House NumberTelephone numbers in case of having to contact children’s family - in order of priority.Order Name Relationship to participant Telephone Observations12

Information Participant 1Name: Surname 1 Surname 2Date of birth: Course attended in 17/18 school yearSchool attended 17/18 Is participant registered for EIC 18/19 school year? YES□ NO□

Care service?(7:30h-9h 25€/Week)

YES□ NO□ Is participant staying for lunch?Parents who collect children before lunch at 13:00 25€/week will be discounted. This request must be made on registration and will not be valid afterwards.

YES□ NO□

Weeks25-29 June

□2 – 6 July

□9–13 July

□16–20 July

□23–27 July

□ACTIVITY CHOICE: SCHOOL:LITTLE □ CAMP □ English□ Castellano□ Català□ Chinese□

Times: 9-13h □ 9-15h □ 9-17h □

September 3-7 LITTLE □ SCHOOL □Information Participant 2

Name: Surname 1 Surname 2

Date of birth: Course attended in 17/18 School attended 17/18 Is participant registered for EIC 18/19 school year? YES□ NO□Care service?(7:30h-9h 25€/Week)

YES□ NO□ Is participant staying for lunch?Parents who collect children before lunch at 13:00 25€/week will be discounted. This request must be made on registration and will not be valid afterwards.

YES□ NO□

Weeks25 - 29 June

□2 – 6 July

□9–13 July

□16–20 July

□23–27 July

□ACTIVITY CHOICE: SCHOOL:LITTLE □ CAMP □ English □ Castellano□ Català □ Chinese □

Times: 9-13h □ 9-15h □ 9-17h □

September 3-7 LITTLE □ SCHOOL □Information Participant 3

Name: Surname 1 Surname 2

Date of birth: Course attended in 17/18School attended 17/18 Is participant registered for EIC 18/19 school year? YES □ NO □

Care service?(7:30h-9h 25€/week)

YES□ NO□ Is participant staying for lunch?Parents who collect children before lunch at 13:00 25€/week will be discounted. This request must be made on registration and will not be valid afterwards.

YES□ NO□

Weeks25 - 29 June

□2 – 6 July

□9 – 13 July

□16 – 20 July

□23 –27 July

□ACTIVITY CHOICE: SCHOOL:LITTLE □ CAMP □ English □ Castellano □ Català □ Chinese□

Times: 9-13h □ 9-15h □ 9-17h □

September 3-7 LITTLE □ SCHOOL □

Parent /Guardian Authorisation

Mr./Mrs.________________________________________________________(Full Name) Identity nº____________________________

As _________________(relationship to participant) I hereby authorise______________________________________ (name/s of participant)to attend the activities organized by ESCOLA INTERNACIONAL DEL CAMP within the programmes of EIC SUMMER PROGRAMMES which will take place from 25th June to 7th September of the current year and with my signature certify the authenticity of all data in this document, including details of travel, medical, image and data protection).

With the completion of this form I hereby authorize specifically that the data contained on this form as well as all documentation included may be dealt with and incorporated in a file which is the responsibility of Foundation Escola Internacional del Camp, CIF G-43731256. L’Escola Internacional del Camp with registration number CIF B555433831 confirms that which is included in articles 15 and 16 of the Law ‘llei Organica 15/1999’ (13 December) regarding Personal Data Protection . Please be informed that you can exercise your right of access, rectification , cancellation or opposition to the school at Salvador Espriu s/n, 43840 Salou (Tarragona).

I will refrain from any legal action, not limited to the risk of injuries that may arise from participating in the event. I authorise the organisers of the EIC SUMMER CAMPUS to record my participation in it through photographs, film, television, radio, video and any other recognised media and waive all rights related to its commercial and advertising use, or any financial benefits therefrom. The registration for EIC SUMMER CAMPUS is personal and non-transferable. No refunds will be allowed, for any reason, of the registration fee. "

Medical InformationDoes the child suffer from any chronic illness?Could it affect their daily activities?Does the child need to take any medication?Times and dose of medication with doctor’s prescription Any food intolerance?Any dietary recommendation?Other observations including allergies.

Other InformationCan your child swim ? YES □ NO □

AuthorizationI hereby authorize my child to join excursions, trips planned in the activity programme as well as any journeys in a school car that may be required for the child or doctor, etc. YES □ NO □I authorise access to the data and protocol of my parental responsibility.

YES □ NO □I authorise that medical decisions that should be required to be taken in case of extreme emergency be taken by the EIC Summer management. YES □ NO □I authorize EIC, ESCOLA INTERNACIONAL DEL CAMP to use visual material such as photos or videos coming from activities carried out by my child during the various EIC SUMMER 2018 PROGRAMMES. YES □ NO □

This document is protected by the current law of professional confidence and data protection by virtue of the LOPD a5/1999 on data protection.Rectification, cancellation and opposition should be directed to the foundation by the stated means.

*Important Documentation to be attached:1.Photocopy of NIC of authorised parent or guardian.2.Photocopy of Medical Card3.Photo of participating child

Salou, _________Date__________________________ 2018 Signature Parent or Guardian.