Lilliput Adventure Summer Camp Booking Form

Summer Camp Booking Form


Your Name:		Child's Name:
Address:		Age:
Address:		Male Female
Telephone:		E-mail Address:
Dates:	Week 1, June 23rd	Week 2, June 30th
	Week 3, July 7th	Week 4, July 14th
	Week 5, July 21st	Week 6, August 28th
Medical history or illnesses we should be aware of: (please specify medications etc.)
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.
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.