Summer Camp Booking Form
 
Your Name: Child's Name:
E-mail Address:

Age:
Telephone: Gender: Male Female
Address: Any medical history or illnesses we should be aware of:
(please specify medications etc.)
 
Swimming Ability: Non-Swimmer Average Competent
 
Dates Required:
(please tick)		 Week 1, June 28th Week 2, July 5th Week 3, July 12th
Week 4, July 19th Week 5, July 26th Week 6, August 2nd
 

Submission of this form MUST be followed by a € 25.00 deposit per child. On receipt of this deposit your child's place will be secured. Balance is payable on first day of camp.
Please forward on your deposit to the following address in the form of a personal cheque, bank draft or postal order in order to secure your booking. (In the event of late cancellation this deposit is non-refundable):
LILLIPUT ADVENTURE CENTRE, Lilliput House, Lough Ennell, Co. Westmeath.

For your information:
At LAC all of our instructors will endeavour to make sure that your group have a fantastic stay with us in a very safe, friendly and fun filled manner. However it is important for you as a leader to realise and be aware that their is an element of risk in all outdoor activities. During your stay here your group will encounter: heights, water, rough terrain, mud and situations that they may not be used to, depending on the weather. We would ask you as a parent or leader to make us aware of any medical conditions that may be of concern to us. We would especially be concerned about diabetes, epilepsy, anaphlaxia, brittle bone syndrome and asthma. You making us aware of these conditions will not prevent anybody from taking part in activities it will merely help our instructors to be more vigilant. We would also ask you to ensure that the people in your care bring the medications that they require.
Thank you, Franky Wright, Manager.

Please read the terms and conditions below before sending the form
I agree that on acceptance of this application that this child will under the guidance of our leaders co-operate with the rules and regulations as laid down by the staff and instructors of Lilliput Adventure Centre.
I also hereby agree to release Lilliput and or its representatives from any and all liabilities in respect of personal injury loss or damage, unless such injury loss or damage is the result of negligence on the part of Lilliput and or its representatives.