BCM Ireland

BCM
BIBLE
CENTRED
M I N I S T R I E S
I N T E R N AT I O N A L
IRELAND
2015
Castledaly Manor
We ask that Parents fill out this form:
Winter (Ages: 14-17)
◻️
Home Phone: ___________________________
Parents Information
School: _________________________________
Forename: __________________________________
________________________________________
Surname: ___________________________________
Class_______________
Address if different: _________________________
____________________________________________
1st - 3rd July
Refocus (5th & 6th Yr students)
◻️
27th - 29th Feb
Youth (Ages: 15-17)
◻️
Friends whom you wish to share with?
Home Phone: _______________________________
________________________________________
Mobile Phone: ______________________________
________________________________________
Email Address in block capitals:
12th-18th July
Senior (Ages: 11-14)
26th
Jul –
1st
__________________________________________
◻️
Aug
Junior (Ages: 8-11)
◻️
2nd-8th Aug
Does the camper have any of the following
Can camp information letter be sent by email?
we should be aware of?
Yes ◻ ️
• Medical Conditions: Yes___ No___
Consent
If yes, please state:
*Please see website for ‘Cookery camp’ &
‘Fellowship work week’ application forms
________________________________________
Campers Information
________________________________________
Forename:______________________________
• Dietary Requirements: Yes ___ No ___
Surname:_______________________________
If yes, please state:
D.O.B: ____________________
________________________________________
Gender: ____________________________
________________________________________
Age at camp: ______________
Emergency Contact: _____________________
Home Address:
Phone Number: _________________________
________________________________________
Family Doctor’s Name: ___________________
________________________________________
Doctors Number: ________________________
________________________________________
Date of Last Tetnus Injection: _____________
No ◻ ️
Please tick to accept:
• I, the Parent/Guardian hereby give my consent for
the above named to attend BCM residential Camp. ◻
• I consent to the above named to participate in all
on-site and off-site activities all under proper
◻
supervision
• I also consent to the above name being included in
photographs of the activities.
◻
In order that the camp be enjoyable for all, certain
rules must apply and I accept that the above
named must abide by these rules.
Signed: Parent/ Guardian
_________________________________________
I enclose: € __________
Cheques or Postal orders to be made out to
BCM
Return to:
Camps Administrator
[email protected]
BCM Camps,
Phone: 090 648 2222
181 Ballinclea Heights,
www.bcmireland.ie
Killiney
Co.Dublin