Belgium 2019 Application

Parent Details
Parent/Carer Name*
First Last
Parent/carer Email Address*
Are you an emergency contact?*
- Yes
- No
Emergency Contact Name 1
First Last
Emergency Contact 1 Relationship to child*
Emergency Contact 1 Home Tel. number*
Emergency Contact 1 Mobile Number*
Emergency Contact 1 Address*
Street Address Address Line 2 City ZIP / Postal Code Country
Emergency Contact Name 2*
First Last
Emergency Contact 2 Relationship to child*
Emergency Contact 2 Home Tel. number*
Emergency Contact 2 Mobile Number*
Emergency Contact 2 Address*
Street Address Address Line 2 City ZIP / Postal Code Country

Travel Information
Passport Number*
Passport Country of Issue*
- UK
Passport Issue Date*
Passport Expiry Date*
Date of Birth*
Nationality*
- British
Please upload a valid passport scan*
Accepted file types: jpg, jpeg, png, pdf.
Do you have EU health card?*
- Yes
- No
Please upload a scan of your EU Health card*
jpg, jpeg, png, pdf)

Terms & Conditions
1. If you have any questions about the details of your booking please contact [email protected]
2. If the pupil requires any medication during the course of the visit/trip, it is the responsibility of the parent/carer to provide the medication in a suitable container which is clearly labelled with the child’s name, drug name & dosage and expiry date. An adequate supply must be provided to cover the duration of the visit/trip.
3. For chronic conditions such as asthma/diabetes/epilepsy etc, it is the responsibility of the parent/carer to ensure more than sufficient supplies and a letter outlining the dosage and method of use are provided. If your child is unable to administer the required medication themselves please ENSURE you make an appointment with either the visit/trip leader or one of the Inclusion Department.
4. All medical conditions/illnesses must have been declared on the application form, before the start of the trip. If there are any subsequent health changes, please contact [email protected]
5. If you would like to discuss your child’s medical history/needs please arrange an appointment with the school nurse.
6. Participants are responsible for any personal belongings/money which are bought on the trip i.e. phones, games consoles, digital cameras and therefore should be locked away in a suitcase when not being used.
Have you read the Terms and Conditions?*
- Yes, I agree with the Terms & Conditions
Other Comments
Name
This field is for validation purposes and should be left unchanged.

Belgium 2019 Application

Step 1 of 5 - Child Details

Child Details

Parent Details

Allergies

Travel Information

Terms & Conditions