Student Registration Form – Junior Summer Camp Students

This form is for students already enrolled on a junior summer camp at Studio Cambridge.

It is essential that this form is completed in full – partially completed responses will not reach us

See our privacy policy for how we take care of your information.

The Student’s Details

Student's name: *

First

Last

Summer camp name

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Student's date of birth: *

Student's email address: *

Student's mobile phone number (including international code): *

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Student's first day at Studio Cambridge: *

Student's final day at Studio Cambridge: *

Parent or Family’s Contact Details

Please write the name of the person we should contact in case of an emergency. This is usually a mother, father, guardian or other relative.

Name: *

First

Last

If 'other' please give details of their relationship to you:

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Their email address: *

Their phone number (including international code): *

Does this person speak English? *

Your Arrival to the UK

Studio Cambridge is required to keep a record of your travel to the UK, even if you were in the UK before your course started. Please tell us the following information.

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The date of your arrival into the UK: *

Your port of entry (which airport, train station, port etc.):

Your method of travel to the UK: *

Your train, flight or ferry number:

Address while in the UK (if not using Studio accommodation)

Only complete this section if you are not using our residential accommodation. If using our accommodation please skip to the next question.

The student's address while staying in the UK:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Health History

Please inform us of any illness, medical conditions, recent operations or serious injuries: *

Allergies: *

Special dietary requirements: *

Is the student asthmatic? *

Immunisation History

Have you been vaccinated against Measles? *

If yes, please give the date:

Date

Have you been vaccinated against Mumps? *

If yes, please give the date:

Date

Have you been vaccinated against Rubella? *

If yes, please give the date:

Date

Have you been vaccinated against Tetanus? *

If yes, please give the date:

Date

Have you been vaccinated against Polio? *

If yes, please give the date:

Date

Have you been vaccinated against Diptheria? *

If yes, please give the date:

Date

Have you been vaccinated against Chicken Pox? *

If yes, please give the date:

Date

Have you been vaccinated against Hepatitis B? *

If yes, please give the date:

Date

Have you been vaccinated against Covid 19? *

If yes, please give the date of your most recent vaccination:

Date

Treatment required

Please give the contact details for your doctor or physician and details about any medication you take.

The student's doctor or physician's contact details. Please include name, practice address, telephone number and email address: *

Medication details (medication name, dosage, times to be given, date when medication should end etc.): *

Learning Difficulties, Disabilities and Special Educational Needs

Please tell us about any learning difficulties and disabilities or special educational needs, e.g. dyslexia: *

Consent

Administration of medication *

I agree

I authorise Studio Cambridge staff to give medication(s) to this student as and when necessary. I authorise Studio Cambridge to contact the student’s doctor if needed. I agree not to hold Studio Cambridge, (its employees or agents who are acting within the scope of their duties), liable should any problems arise from the administration of the medication the student requires. I agree to inform Studio Cambridge immediately, and in writing, of any change in the medication order. In the event of an emergency, I hereby give my consent to the local physician to secure proper treatment for this student.

Personal transport and free time *

I agree

I understand that if my son/daughter is in homestay accommodation, he/she will need to get to and from school by themselves, and that this may include a journey by bus (unsupervised). I understand that if my son/daughter is in residential accommodation on a Sir Michael or adult course, he/she may need to walk/travel (unsupervised) to and from their accommodation and school. I understand that Studio Cambridge does not recommend that students studying in Cambridge hire bicycles to travel around the city, especially if they are under 18 and/or an inexperienced cyclist. I understand that my son/daughter will have periods of unsupervised free time, as specified in the pre-arrival information (dependant on course).

Media materials *

I agree
I do not wish for my / the person under my guardianship or parentage’s image to be used by Studio Cambridge for marketing or social media purposes

It is Studio Cambridge policy to allow staff, students, leaders and other authorised guests to take photos or video of Studio students in public areas of the course centre whilst attending a course of camp. By ticking the box you agree to such media materials relating to the student being used by Studio Cambridge for marketing and social media purposes, or by other students or guests for personal use.

Parent/Legal Guardian's Name *

First

Last

Parent/Legal Guardian's signature: *

Please check the box to sign

The Student’s Details

Parent or Family’s Contact Details

Your Arrival to the UK

Address while in the UK (if not using Studio accommodation)

Health History

Immunisation History

Treatment required

Learning Difficulties, Disabilities and Special Educational Needs

Consent

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