Summer YAP Green Enterprise Booking Form

NCAD YAP Summer Camp Enterprise Workshops Booking Form

Please fill in all the details below to book a place on the Green Enterprise Summer camp in the REDISCOVERY CENTRE in Ballymun from 17th-21st July 2017 (9.30am-3.00pm) AND/OR the Creative Enterprise Summer Camp in the NCAD from 24th to 28th July 2017.

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* 1. Student Details

Name:

Address:

Address 2:

Town:

County:

Date of Birth:

Age:

School Name:

Current Academic year in School:

Medical - please list any medical conditions or allergies we should be aware of:

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* 2. Please indicate which workshop/s you wish to attend.

Green Enterprise workshop 17-21st July Rediscovery Centre Ballymun

Creative Enterprise workshop 24-28th July NCAD

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* 3. Parent / Guardian Details:

Name:

Address:

Address 2:

Town:

County:

Email Address:

Phone Number:

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* 4. Emergency Contact Details

Name:

Phone:

Relationship to student:

Second Contact Name:

Phone:

Relationship to student: