ENROLLMENT FORM CHILD INFORMATION Name, Surname and Family name of the child * Please, write them in Latin too (As they are written on the ID/Passport). Date of Birth PIN (for insurance) Nationality * Age * Phone number Extra Curricular activities and interests Transport * Both ways Departure only Return only Camp dates * 9 - 18 July - Limnos, Camp 1 22 - 31 July - Limnos, Camp 2 5 - 14 August - Limnos, Camp 3 26 August - 4 September - Limnos, Camp 4 PARENTS INFORMATION Mother * First Name Last Name Phone (###) ### #### Email * Father * First Name Last Name Phone * (###) ### #### Email * HEALTH STATUS OF THE CHILD Were there any injuries in the last month? If yes, what? Does the child have any diseases? If yes, what? Does the child have any allergies? If yes, what? Does the child take any medicine? If yes, what? Does the child have a special diet? If yes, what? Name and telephone number of the GP: * Thank you!