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Citywise Education provides young people with after-school and

out-of-school educational support

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Book Afterschool

Fast Track Form

Summer Camp Draw Member Form 2022

Sign Up Online for our Summer Camp

Book Now. Our Summer Camp runs from Monday 19th June - Friday 3rd August 2021.

Limited Places!

Summer Camp Registration

This Form is for DRAW MEMBERS ONLY!!!

The registration fee is €45 per child. Please fill one form per person.

Childs First Name

Childs Last Name

Email

Date of Birth

School

Class

Which camp would you like to register for?

Emergency Number & Contact Person

Parent/Guardian Phone

Address

Are there any medical facts we need to know about your child?

PARENTAL CONSENT: I give permission for my child to attend this camp, and for photographs, images and video of them to be taken, to be used for promotional purposes in future.

Thanks for submitting!

Durkan Centre, Fortunestown Way, Jobstown, Dublin 24, D24 W284

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