UISCE Online Booking

Application form for Course Cúrsa C - Eachléim (Bean an Tí) (2018)

Student Details

Gender*

Student First Name*

Student Surname*

Student Date of Birth*

DD/MM/YYYY

Address line 1*

Address line 2

Town/City*

County

Country*

School Details

Class (Your Current School Year)*

If you are booking in June or July please state the school year just completed

Standard of Irish/ Your next State Exam*

School Name*

Irish Teacher

Course Information

Health Issues/Allergies/Medication Requirements

Can you swim?*

Friend

Do you have a friend that you would like to share accommodation with? (please note a maximum of one friend can be listed and both forms must correspond)

Special Requirements

How did you hear about UISCE?*

In accordance with the Code of Ethics and Good Practice in children's sport Coláiste UISCE wishes to advise parents that photos may be taken of your child during activities. The photos may then be used on marketing and promotional materials for UISCE.
UISCE is in compliance with the code of ethics guidelines for best practices.
Please tick the box if you would like your child to be excluded in photography taken by UISCE.

Parent Details

Parent First Name*

Parent Surname*

Parent Email*

This will be your login name on this site

Mobile Number*

(required for emergency contact only, e.g. 353861234567)

Emergency Contact Details

Emergency contact First Name*

(in event of parent being uncontactable)

Emergency contact Surname*

Emergency contact Phone number*

Terms and Conditions

Click here to confirm that both Student and Parent/Guardian have read and accept the Booking Terms and Conditions and Refund Policy above*

Travel Information

Travel to Uisce

Travel from Uisce

Payment Details

Payment Amount*

Voucher Code

Voucher codes are case sensitive

Personal Pupil Accident Insurance Required, €9 per student?

Students are advised to take out their own personal accident insurance before coming on the course. Details of a sample policy from Allianz Ireland are available by clicking here. In the event of an accident, this policy will cover all doctors, hospital, medical and physiotherapy bills should your child require medical assistance as a result of an accident while at Coláiste UISCE. The policy has no excess or minimum claim amount. We believe that this insurance represents excellent value for money and therefore recommend availing of this cover. To avail of the cover please tick the appropriate box.

Preview Payment

Course: Cúrsa C - Eachléim (Bean an Tí) (2018)
Course Cost: €920.00
Selected Payment Amount: €0.00
Travel to Uisce Cost: €0.00
Travel from Uisce Cost: €0.00
Insurance Cost: €0.00
Handling Charge (1.60%): €0.00
Discount: -€0.00
Amount Payable: €0.00

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