Health, Medical & Insurance Details

Student's Name *

Parent's Email *

All students in the Summer Camp are covered by basic accident insurance. This is likely to cover all medical costs should an accident occur. However, parents are advised to organize general health cover for their children during Summer Camp. Therefore please give details below of your child’s own private medical insurance below.

Name of Insured (student) *

Name of Insurance Company *

Policy Number *

Insurance Company Contact Number *

If available please upload a copy of the insurance card or policy

Click or drag files to this area to upload. You can upload up to 2 files.

If considered necessary, do you agree to a mild pain killer being given? (Tylenol) *

Yes
No

Has your child been vaccinated against Tetanus in the last 10 years? *

Yes
No

Has your child received medical or surgical treatment of any kind? *

Yes
No

Medical or surgical treatment

Has your child been given specific medical advice to follow in emergencies? *

Yes
No

Medical advice to follow in emergencies

Has the participant had any of the following?

Please give details

Behaviour

BISP expects a high standard of behaviour from all Summer Camp participants, and expects them to show respect to each other and BISP staff.

Behaviour *

I understand that if the participant named above, engages in any disruptive antisocial behaviour they may be immediately sent home from the camp without a refund.

Consent

Confirmation *

I confirm that I have parental responsibility for the participant named above. He/she is in good health and I consider him/her to be capable of taking part in the activities. I give consent for him/her to take part in the Summer Camp programme..

Consent *

In the event of illness or accident, I consent to any necessary medical treatment, which might include the use of anaesthetic.

Responsible Parent's Full Name *