Student Registration

Student

Forename

Surname

Date of Birth

Gender
MaleFemale

Nationality

Mobile

Client, Parent or Guardian

Forename

Surname

Address

Country

Mobile

Phone

Email

General information about the student

Please note that most of the information about the student is only required for host family placing purposes; if you wish to book a course without host family accommodation, you may leave this section blank except for the fields "language tuition" and "level". Thank you.

Allergies and/or Disabilities?
NoYes

If yes, please specify...

Any special catering needs?

Smoker?
NoYes

Chronic Diseases i.e. asthma

Regular medical treatment

Permission to go swimming?
NoYes

Other languages spoken

General comments, special wishes, emergency contacts

Course Data

Course Type
Junior HolidayJunior IntensiveAdult/Senior Citizens GeneralBusiness EnglishPrivate Tuition (one-to-oneOther Language (specify below)

Other language required

Language tuition since

Level
BeginnerIntermediateAdvanced

Start date (normally a Monday)

End date (normally a Friday)

Airport transfers to Torquay can be arranged subject to availability.

Accommodation

Accommodation required?
YesNo

Accommodation type
Host FamilyBed & BreakfastHotelOther (please specify)

Other accommodation type

Student would like to share with

Single room?
YesNoThird choice

Start date (check-in)

End date (check-out)

Course Price

Course fee

Course currency
British Pounds £

Single room supplement

Accommodation fee

Discounts (if applicable)

Total price

Transfer by National Express coach required
YesNo

MINIMUM AGE 14 (cost will be about £65 incl. £5 booking fee for a return ticket from/to Heathrow - depending on booking date).

IMPORTANT: We must receive the total amount on any invoice in English Pounds and all Bank Charges should be paid by the student. Details of the Schools Bank Account will be included in the invoice.

Payment

A minimum deposit of £200 is payable on Registration and will be deducted from the final invoice. The balance of the course fee is due twenty eight days prior to the commencement of the Course.

Form of Payment
Invoice

By ticking this box I accept EFA's general booking conditions and reserve this course. For students aged under 18, a parent / guardian must give full consent to attend our courses.

Email

Parent Authorisation

Parents' Details

Father's full name

Nom - Prénom père / Name - Vorname Vater

Mother's full name

Nom - Prénom mère / Name - Vorname Mutter

Email

Obligatory / obligatoire / Pflichtangabe

Child's details

Child's name

Authorise My Child

Autorise mon enfant / autorisiere mein Kind

Child's age

Alter

Registered with the EFA Torquay Junior Programme from:

Inscrit au programme EFA. Torquay Junior du Eingeschrieben am EFA. Torquay Junior-Programm vom:

Adult Authorisation

To go out at night after 8pm until / A sortir le soir après 20h jusqu’à Abends nach 20 Uhr auszugehen bis um
PM weekdays

heures en semaine / Uhr wochentags

PM Saturdays

heures le samedi soir / Uhr samstags

Authorisation Declined - I do not authorise my child to go out after 8pm at night at all. Je n’autorise pas mon enfant à sortir seul le soir après 20 heures, ni la semaine, ni le samedi. Ich erlaube meinem Kind nicht, allein weder wochentags noch samstags abends nach 20 Uhr auszugehen.

Declaration by the parents and students

Parent: We certify that our child will respect the instructions given above and E.F.A. will not be held responsible if our child does not meet the regulations. Les Parents: Nous certifions que notre enfant respectera les consignes données cidessus et que E.F.A. ne sera pas tenue pour responsable si notre enfant ne respecte pas le règlement. Erklärung der Eltern: Wir attestieren, daß unser Kind die obenstehenden Instruktionen respektieren wird und E.F.A. nicht dafür haftbar gemacht wird, wenn unser Kind sich nicht an diese Anweisungen hält.

Parent Declaration*
Agree

Date

Email

This field is for validation purposes and should be left unchanged.