Anyone 4 Science Workshop Booking Form 
Workshop dates and venue No. of Children Cost

 

 

    

Please complete for each child attending a workshop: 

Child's name:__________________  Age:_______

Special health /dietary or other relevant information:
_________________________________________

_________________________________________

I agree to abide by the camp rules as outlined in this brochure.

Child's signature:___________________________
_______________________

Child's name:__________________  Age:_______

Special health /dietary or other relevant information:
_________________________________________

_________________________________________

I agree to abide by the camp rules as outlined in this brochure.

Child's signature:___________________________
_______________________

Child's name:__________________  Age:_______

Special health /dietary or other relevant information:
_________________________________________

_________________________________________

I agree to abide by the camp rules as outlined in this brochure.

Child's signature:___________________________
_______________________

  

Contact Details

Name: _________________________

Address: _____________________________  

____________________________________

Phone: ____________________

e-mail:_____________________________

Contact no. during camp:___________

Non-refundable fee of €____ enclosed.

We recommend that children wear safety glasses for some activities.  These can be purchased for €5 at the venue.

Signed: _________________     ___________
            Parent / Guardian                Date

Please return completed forms to:

Christine Campbell
Anyone 4 Science
Ballyduff
Ashford
Co. Wicklow

Anyone 4 Science Rules:

Instructions from staff members must be obeyed.

Children must be safety conscious at all times.

Children must not leave the premises without permission.