Inscrição - Cambridge Academy

Student information

Please ensure all sections of this form are completed

Family Name *

First Name(s) *

What does your child like to be called? *

Date of birth *

Age (at the start of course) *

Gender *

Languages spoken *

Nationality *

Passport no. *

Expiry date *

Home details/ Emergency contact

this person should be available 24 hours a day and speak English)

Full Student Home address *

Emergency contact name *

Contact telephone number(s) #1 *

Contact telephone number(s) #2 *

Relation to child *

English speaker *YesNo

Email address #1 *

Email address #2 *

Course details

I wish to enrol my child on the following course

Course dates - (DD/MM/YY)

From *

To *

BOOKING NOTES**

What is your child’s level of English?

Notes

Provisional Travel Arrangements (if available)

NB: Do NOT book flights until booking confirmation is received. Inclusive airport transfer applies to flights scheduled to land/ depart between 09.00 and 19.00 and to/ from specified airports. Other transfers can be booked at a charge.

Arriving on *

Airport *

Terminal *

Flight number *

Time of arrival *

Departing on *

Airport *

Terminal *

Flight number *

Time of departure *

Full Name *

Date of birth *

Course *PHCOBHMHOther

Course dates *

Medical/Welfare Information

(add full details on a separate sheet if appropriate)

Has your child studied at CAE before? *YesNo

When?

Does your child have any special dietary needs? *YesNo

Does your child have any relevant medical history CAE should know about? *YesNoe.g. asthma, disability, allergy, surgery or serious illness in the last 12 months

Is your child receiving medication? *YesNo

Will your child bring any medicines with them? *YesNo

Do you consent to your child being given non-prescription medication, where appropriate? *YesNo

Has your child had a tetanus vaccination? *YesNo

Do you allow your child to swim? *YesNo

Can they swim 25 metres? *YesNo

Which type of room would your child prefer?
Note: preferences cannot be guaranteed

No preferencedormitorytwinsingle

I understand that my child will be expected to follow the Excursion Safety Guidelines, at all times

YesNo

I understand that the scheduled activity programme may include limited unsupervised time on excursions

YesNo

I give permission for my child to take part in such unsupervised scheduled activities

YesNo

If my child is living in a homestay, or in off-site accommodation, I allow my child to walk to/ from school

YesNo

I give permission for my child’s picture to be used for CAE promotional purposes.

YesNo

SPECIAL NOTES: Give details of any other special requests/ medical or personal information that may be relevant to your child’s stay with CAE

Payment of fees

Contact [email protected] with any questions or concerns or to confirm payment.

BANK TRANSFER

STERLING (£) payments to Cambridge Academy of English (The Willow Education Limited)

Account name

Bank name

Account no

Sort Code

International IBAN no

BIC

I understand that I should include Student Reference and Family Name with payment, and confirm with CAE by email.I understand that this is a Sterling (£) account, and that remittance should be made in Sterling GBP.

CARD PAYMENT

I would like to make a card payment. Contact CAE for advice.

I AM NOT RESPONSIBLE FOR PAYMENT OF FEES

I will provide full details of who is responsible for payment of fees to CAE.

Parental Consent

This section must be completed to ensure your child’s full participation on the course.

I hereby consent to the full participation of my child (named above) on the course.I confirm that the information provided is complete and true. I understand that information will be stored and used for CAE purposes only and in accordance with our Privacy Policy. I understand that I must notify CAE of any changes, or information relevant to the health and welfare of my child, and/or others, and to their suitability for a residential or homestay course.I authorise CAE to be responsible for my child’s welfare for the duration of the course. I give consent for a doctor to administer necessary medical treatment, including anaesthetic and operation, if I cannot be contacted in an emergency.

Full name of Parent/ Guardian *

Relationship to child (named above) *

Signature *

Date *

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CAE Young Learners 2025

Enrolment and Parental Consent Form

Student information

Home details/ Emergency contact

Course details

What is your child’s level of English?

Provisional Travel Arrangements (if available)

Medical/Welfare Information

Payment of fees

Parental Consent