Morton Summer Camps 2013 Brochure - Greenock Morton ...

Morton Summer Camps Application Form
Book online at www.mortoncommunity.net
Your Details
Name:
Address:
Daytime Telephone:
Email Address:
Relationship to Child:
Post Code:
Mobile:
Your Childs Details
Child’s Name:
Date of Birth:
Does your child have any medical conditions ( please tick )
No Yes (if yes please give details below, including any medication taken by your child.
If your child will have medication with them at the course please provide details)
Does your child have any allergies? (please tick appropriate box)
No Yes (if yes, please give details below)
PAYMENT DETAILS
Course Choice – Which course would you like to book your child on?
Venue Week Option Camp option Code Cost
Payment - Total Cost of booking £
Payment Method ( please tick where appropriate )
Cash Cheque Cheque should be made payable to: Greenock Morton Community Trust
If paying by credit or debit card please complete the following section
Card Type
Card type example: visa debit / credit card / master card / amex
Long number
Valid from Valid To :
Name on Card
3 Digit Number : Amount
CALL 01475 723571 TO PAY BY CARD
Greenock Morton Community Trust and/or its nominated photographer will take pictures at the event for
marketing and promotional purposes. If you do not wish to have your child photographed please tick the box
All completed application forms along with payment should be returned to: Morton Summer Camps 2013,
Greenock Morton Community Trust, Cappielow Stadium Sinclair St, Greenock PA15 2TY
Email: admin@gmfc.net - www.mortoncommunity.net
Like us on Twitter: @mortoncommunity - facebook.com/MortonCommunity
Registered Charity number SCO40819