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2018-10-10T14:25:48+00:00
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*
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*
DD slash MM slash YYYY
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*
DD slash MM slash YYYY
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*
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I don't need transfer for my group
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Comments
Please use the space for any comments. Specially if you have selected "Other" or " I don't need transfer for my group"
Arrival Flight details
Departure Flight details
Group details
List
First Name
Surname
Sex
Date of Birth dd/mm/yyyy
Programme Choice
English Level
Student's mobile number
Emergency mobile number
Allergies/Diet requirements
Parental consent
Sharing room with
F
M
Other
Prefer not to say
Mini Stay
Exploring Devon
Adventure Sports
Balls Sports
Beach Volleyball
Football
Musical Theatre Academy
Riding
Sea Water Sports
Sport Science
Street Dance
Surfing
Table Tennis
Tennis
Not sure
A2
B1
B2
C1
C2
None reported
Allergy-animals'hair
Allergy-nuts
Allergy-ashma
Diet-Gluten free
Diet-Lactose free
Diet-Vegetarian
Other
YES
NO
Please indicate in the column above if you have consent from the students's parents for the following: -
Photos and Videos
being taken of the student and used in publicity materials or social media either individually or as part of a group. -
Additional Freedom
. Parents agree with the levels of supervision offered to students at Country Cousins and are aware on additional freedom around town or with staff members at limited times. For children aged 11-15 they will presume students may have additional freedom.
Student's with no parental consent
First Name
Surname
Consent to Photo/Videos
Consent to Additional Freedom
Yes
No
Yes
No
Please indicate students names if they haven't been authorised to be part of the photos/videos used in publicity materials or social media either individually or as part of a group, and Additional freedom. • Social Media- Consent for photograph/videos of the student used on social platforms, such as Instagram/Facebook either individually or as part of a group
Group Leaders details
How many Group Leaders are coming with your group please?
Please select a number and complete their details below.
1
2
3
4
List
First Name
Surname
Sex
Date of Birth (dd/mm/yyyy)
Contact mobile number
Next of Kin number for emergencies
Allergies/Diet requirements
Safeguarding Awareness Online
Police Checks Certificate
F
M
Other
Prefer not to say
Yes
Not Yet
Yes
No
Not Yet
Please complete the online course as soon as you can https://accreditation-uk.english.britishcouncil.org/
Safeguarding Certificates
Please note that each group leader should have its own certificate.
Drop files here or
Select files
Max. file size: 256 MB.
Police Checks Certificates
Please note that each group leader should have its own certificate.
Drop files here or
Select files
Max. file size: 256 MB.
Consent
*
By signing below, I agree on behalf of the Agency detailed above, to the following stipulations:Country Cousins documents and terms and conditions above.
• We confirm that the above details are accurate and complete
• We agree to Country Cousins terms and conditions
• We agree we have obtained individual parental consent for each of the following areas: Photos/Videos and Additonal Freedom
Δ
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