Registration Form for the Peter Pan course 26th July to 08 August 2010

Parents wishing to participate in language or music course must register in the main course

1) You can print it and fax it (01454 41 95 34 51) or from overseas  + 44 1454 41 95 34 51              

 Please fill up a file for each member of the family (parent or child)

2) Or you can copy it, fill it and send it back by attachment e-mail

Nota bene: we do not open attachments unless we have been sent an e-mail previously

Parent form

Given names

 

Name

 

Date of birth

 

Nationality

 

Gender M/F

 

Tel

Fax

E-mail

Address 1

 

Address 2

County

Town

Zip code

Country

Skype name if any:

 

 

I have read all the Information page and agree with the conditions

Date

 

Signature

 

We wish to arrive on 25th July 2010

 

Registration Form for the Peter Pan course Child

 

 

 

Given names

 

Name

 

Date of birth

 

Nationality

 

Gender

 

 

Language abilities

 

Main first spoken language

 

Second spoken language

 

 

Main first written language

 

Second written Language

 

 

Third spoken language

 

Third written language

 

 

Music choices on the course

 

We take children from debutant to grade 4

Debutant or number of years

 

1st instrument

 

Level

 

 

2n d instrument if applicable

 

Level

 

 

3rd instrument if applicable

 

Level

 

 

Full board and lodging

Day only all meals

 

Optional Language course choices

 

 

French

English

German

Spanish

Russian

 

One to one

 

 

 

 

 

 

In small group

 

 

 

 

 

 

1 hour per day

 

 

 

 

 

 

2 hours per day

 

 

 

 

 

 

Optional Tennis lessons in group of 4

 

10 half hours 70

 

10 hours 100

 

Your child musical details: Music school she (he) belongs to (if any)

 

 

 

Something you would like us to know about your child