Student Information / Information de l'élève

Student Name / Nom de l'élève *

Student Name / Nom de l'élève

First Name

Last Name

Gender / Sexe *

Female / Féminin

Male / Masculin

Birth Date / Date de naissance *

Birth Date / Date de naissance

YYYY

Place of Birth / Lieu de naissance *

Nationality / Nationalité *

Passport No. / N° de passeport

Passport, valid until / Passeport valable jusqu'au

YYYY

Mother Tongue / Langue maternelle *

Other languages spoken / Autre(s) langue(s)

Optional: French conversational classes

Main language during camp is English and for all activities and workshops a basic English understanding is sufficient. For students who want to improve their French language skills we offer optional French conversational classes (15 hours) for 500 CHF

French conversational classes (15 hours) for 500 CHF

Optional: Personal Photos

5 beautiful personal portraits and 2 group pictures made by our in-house trainer and professional photographer who has been shortlisted for the Sony World Photography Awards and other leading worldwide photography competitions.

5 Personal photos + 2 Group Photos for 150 CHF

Session Selection / Sélection de session

Boarding or Day / Internat ou Camp de jour *

Boarding / Internat

Day / Camp de jour

Summer Camp Session *

Please select your summer camp session 3 or 4 week sessions are also available upon request, also see the requests at the bottom of the form — Insurance is compulsory for all non-Swiss residents and is charged extra, cost: 250CHF. Fees are all inclusive and also include pick up from and drop off to Geneva Airport.

A: Two weeks — Mon 1st July to Sun 14th July 2019 — Boarding: CHF 5.000, Day CHF 2.750 / Deux semaines — Du lundi 1 juillet au dimanche 14 juillet 2019 — Internat: CHF 5.000, Jour CHF 2.750

B: Two weeks — Mon 15th July to Sun 28th July 2019 — Boarding: CHF 5.000, Day CHF 2.750 / Deux semaines — Du lundi 15 juillet au dimanche 28 juillet 2019 — Internat: CHF 5.000 Jour CHF 2.750

C: Two weeks — Mon 29th July to Sun 11th August 2019 — Boarding: CHF 5.000, Day CHF 2.750 / Deux semaines — Du lundi 29 juillet au dimanche 11 august 2019 — Internat: CHF 5.000, Jour CHF 2.750

Parent Information / Information des parents

Parent Name / Nom du parent *

Parent Name / Nom du parent

First Name

Last Name

Parent Email Address / Email *

Parent Address / Adresse de parent *

Parent Address 2 / Adresse de parent 2

Parent City / Ville *

Parent State / Province

Parent Postal Code / Code postal *

Parent Country / Pays *

Parent Phone Number / Téléphone

Special requests / Demandes spéciales

How did you hear about the camp?

Agent Information / Information Agents (section reserved for agents / section réservée aux agents)

Agency Name / Nom de l'agence

Contact person / personne de contact

Address / Adresse

Email Address / Email

Phone Number / Téléphone

Billing address/ Adresse de facturation:

Parents

Agent

Terms and Conditions *

By submitting this form you accept the terms and conditions

I have read and accept the terms and conditions

Many thanks for your registration.

We will be in contact soon. In the meantime, if you have any further questions, please email us: challengecamp@champittet.ch or call us : + 41 21 721 05 05

Merci pour votre inscription.

Nous vous contacterons prochainement, d’ici là et si vous avez des questions, n’hésitez pas à nous contacter par courriel: challengecamp@champittet.ch ou par telephone: + 41 21 721 05 05

Apply for summer camp 2019