International Summer Camp Montana Application Form
I hereby apply for admission of my child(ren) to International Summer Camp Montana for Summer 2010 :
Please register one camper per line:  
Surname/first name of camper:* Day/Month/Year of birth Gender:* Height:– Language(s) spoken:*
1. Surname:
First Name:

m f

cm
2. Surname:
First Name:
m f cm
3. Surname:
First Name:
m f cm
 
Session(s) of Enrollment Arrival day Departure day
 1st Session Sunday, 27 June 2010 Saturday, 17 July 2010
 2nd Session Sunday, 18 July 2010 Saturday, 7 August 2010
 3rd Session Sunday, 8 August 2010 Saturday, 28 August 2010
 
Language Course(s) Required English French Spanish None Desired
 
Parent/Guardian
Home Address:
Mr Mrs
Surname:*
First Name:*
E-Mail:*
Street & No.:*
P.O. Box:
Town/Zip Code:*
Country:*
Telephone:*
Fax:
Mobile phone:*
Profession:
Business Address:
Company name:*
Street & No.:*
P.O. Box:
Town/Zip Code:*
Country:*
Telephone:*
Fax:
Mobile phone:*
 
Payment of the non-refundable and non-transferable deposit (CHF 1’500.–/US$ 1’415.–/€ 970.–* per camper, per session)
Amount sent: CHF *
By Cheque
By Bank transfer IBAN: CH54-0024-3243-H668-0498-0 (UBS SA, CH-1002 Lausanne, Account Nr. H6680498.0, bank clearing 0243)

Applications will only be confirmed on a space available basis and upon reception of a cheque or a copy of bank transfer. A letter of recommendation is required from a teacher for new campers.
 
Please check the box to confirm that you have carefully read, understood an agree to the terms and conditions specified in our general information. You also understand that the final balance must be received by 30th April 2010. For applications received after 30th April 2010, the balance is due upon confirmation of the reservation. International Summer Camp Montana reserves the right to cancel the enrollment if these conditions are not satisfied.