Booking Form for Bethany Centre 2010

To book a place at International Summer School at Bethany Centre please complete the following form. We will contact you with regards to payment which can be done by credit card via fax. Please do NOT enter your credit-card details below or e-mail them to us!

Booking Form

Before completing the form please read the Terms and Conditions.

Student Details
Family Name:
First Name:
	Boy Girl
Nationality:
Date of Birth:	Day 12345678910111213141516171819202122232425262728293031 Month 123456789101112 Year 198519861987198819891990199119921993199419951996199719981999200020012002
First Language:
Knowledge of English:	Beginner Elementary Intermediate Advanced
Is the student in good health:	Yes No
If "No", please provide details:
Do you require insurance? (£48 for length of stay. See Terms and Conditions for details.):	Yes No
Parental Details
Name of parent or guardian:
E-Mail Address:
Postal Address:
Home Telephone:
Work Telephone:
Fax:
Emergency Contact Details
Name of emergency contact:
Address:
Home Telephone:
Work Telephone:
Fax:
How did you hear about International Summer School [ISS]:
Airport Transfer: Meet and Greet Service We are happy to meet children at Heathrow, Gatwick, Stansted and London City airports, and Eurostar Train stations at Ashford, Ebbsfleet and St Pancras. Children are met by I.S.S. staff who transfer them to the school. On departure ISS Staff will accompany children to the Airport/Train Station and assist with check-in and stay with them until they go through to passports. Discounts are available if students are travelling together.
Do you require airport transfer?	Yes No
If "Yes" please choose airport/train station:	Heathrow (£180 return) Gatwick (£145 return) Ashford (£110 return) Stansted (£210 return) St Pancras (£240 return) Ebbsfleet (£140 return) London City (£160 return)
The cost for our "meet and greet" transfer service includes pick up of your son/daughter by our staff on arrival and transfer to International Summer School. On return to the airport or train station on departure, our staff will assist with check in and will stay with your son/daughter until he/she goes through to Passport Control.
If you require our additional waiting service where International Summer School staff remain in the airport or train terminal building until the flight or train departs - this is available by ticking the box:	Waiting service (£30)
Discounts on transfers are available to students who arrive/depart together.
Weeks Required Please select your preferred dates.
Total number of weeks (Price per week £640):
Single en-suite bedroom (Extra £50 per week):	Yes No
Summer:	4th July - 10th July 11th July - 17th July 18th July - 24th July 25th July - 31st July
Later weeks are available at Moira House Centre in Eastbourne. (ISS staff will transport your son/daughter to Moira House on 24 July at no extra cost)
Optional Activities You can only do one activity per week.
Sailing 6 hours per week £110	Number of weeks:
Canoeing 6 hours per week £110	Number of weeks:
Windsurfing 6 hours per week £110	Number of weeks:
Mountain Biking 2 hours per week £38	Number of weeks:
Tennis 6 hours per week £115	Number of weeks:
Golf 6 hours per week £135	Number of weeks:
Horse riding 1 hour per week £50	Number of weeks:
Horse riding 2 hours per week £100	Number of weeks:
Horse riding 3 hours per week £150	Number of weeks:
By submitting the form you state that you have read and agree with the Terms and Conditions. Records will be maintained and divulged to third parties only within the provisions of the Data Protection Act