SUMMER CAMP REGISTRATION FORM


Surname * Name *
Address * ZIP Code * City * Country *
Birth place * Birth date * Home phone Email *
Mobile number Frequent School Name Hear From
how did you know about the MB International Summer Camp
PARENT 1: Surname and Name: * Mobile phone * Email *
PARENT 2: Surname and Name Mobile phone Email
 
COURSE INFO:
Program Selected * Preferred Language * Language Level * Sports *
Weeks From to I wish to stay with
 
TRAVEL DATA:
Arrival at * Departure from * Travel Notes
PERSONAL INFORMATION:
Does the student suffer from particular illnesses, allergies or food problems or take medication regularly?
Favorite Hobbies & Sports
MB Enrollment Fee
110,00 €
Package Price
0,00
Transfer from airport / station on arrival * Yes No
0,00
Transfer From airport / station on departure * Yes No
0,00
Cancellation insurance (6% of total) * Yes No
Additional medical insurance (45) * Yes No
 
NB: THE FINAL PRICE, AT THE TIME OF THE BALANCE, CAN BE SUBJECT TO VARIATIONS DUE TO CHANGES IN CURRENCY
Deposit amount
 
AUTHORIZATION OF PARENTS FOR STUDENTS OF 18 YEARS
I declare to have read and approved the information and the general conditions provided by MB * Yes No
I authorize my child to leave the village without supervision (only 16+) * Yes No
I authorize the school to provide immediate medical assistance * Yes No
 
I pay the deposit and send a copy of payment by email by *
Credit Card or Paypal
Bank transfer to: BANCA MONTE DEI PASCHI DI SIENA SPA (IBAN: IT59T0103012190000003141010 BIC: PASCITMMXXX)
 
I confirm to have read and abide to the rules and the information provided by the data protection law D.Lgs. 101 del 10/08/2018 *
GIVE YOUR CONSENT TO THE PROCESSING OF PERSONAL AND / OR SENSITIVE DATA NECESSARY FOR THE PERFORMANCE OF THE TRANSACTIONS INDICATED IN THE ABOVE, INCLUDED THE PROMOTIONAL AND ADVERTISING
PROVIDE YOUR CONSENT TO THE PROCESSING OF PERSONAL AND / OR SENSITIVE DATA NECESSARY FOR THE PERFORMANCE OF THE TRANSACTIONS INDICATED IN THE ABOVE, EXCLUSION OF THE PROMOTIONAL AND ADVERTISING