Student’s last name:

Student’s first name:

 Male Female

Date of birth (d/m/y):

Nationality:

Passport no:

Date and place of issue:

Religion:
---African Traditional & DiasporicAgnosticAtheistBaha'iBuddhismCao DaiChinese traditional religionChristianityHinduismIslamJainismJucheJudaismNeo-PaganismNonreligiousRastafarianismSecularShintoSikhismSpiritismTenrikyoUnitarian-UniversalismZoroastrianismprimal-indigenousother...

Father’s last name:

Father’s first name:

Mother’s last name:

Mother’s first name:

Address:
your address here ...

Zip code:

City:

Country:

Phone:

Fax:

Father’s cell phone:

Mother’s cell phone:

Father’s e-mail:

Mother’s e-mail:

CHAMPITTET SUMMER CAMP 2012

CAMP DURATION:

Boarding School

Camp A (first two weeks only) 01-15/07
Camp B (Last two weeks only) 15-28/07
Camp C (Full camp) 01-28/07

 Camp A Camp B Camp C

Day School

Camp D (first two weeks only) 02-14/07
Camp E (Last two weeks only) 16-27/07
Camp F (Full camp) 02-27/07

 Camp D Camp E Camp F

CHALLENGES TO TAKE UP :

During the camps A, C, D and F (first two weeks)
 Alpine Challenge Water Challenge

During the camps B, C, E and F (last two weeks)
 Alpine Challenge Water Challenge

Language classes:

 French English

Level

 Beginner Intermediate Advanced

Comments/special communications

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Financial conditions

BOARDING SCHOOL

Two weeks fee (Camp A and B) : CHF 3’800*.–

Full camp fee (Camp C): CHF 6’400*.–

DAY SCHOOL

Two weeks fee (Camp D and E) : CHF 1’900*.–

Full camp fee (Camp F): CHF 3’800*.–