(Note: To participate in Toka’s programs is necessary filling in the form of participation in the program. You can download the document here to fill and send to info@toka-ks.org)

 

PARTICIPATION FORM FOR THE PROGRAM_________________________

Kosovo, Pristina, (Month, Day, Year)

NAME AND SURNAME OF PARTICIPANT________________________

RESIDENCE                                                  ________________________

To be part of the program, parent’s permission is requried as follows:
☐ Your son/daughter is allowed to participate in this program.

☐ I agree to bring my son/daughter at the location announced by TOKA.

☐ After completion of this form, I will sign this and the document of permission/approval for participation.

Please inform us if your son/daughter has special needs and requires special care, for example:

Sympotoms Yes No
Allergy to any food or something else
Had a Medical Operation recently
Previous physical wound (e.g bone fracture)
Fobia from heights
Has been sick on last month
Sleeping problems
If your son/daughter has any other medical needs that requires special assistance and care from the organizers, please write them below:

 

 

Please confirm that your son/daughter is complitely vaccinated with all the vaccines applied to him/ her_

  Yes           No

TBC Vaccine
Immunity Vaccine
Others (please write):

 

 

 

Please share with us your preferencies regarding the freedom your son/daughter would have during the camp:

Yes         No

I want my son/daughter to go to sleep in a specific time – if yes, write the time please
My son/daughter should always be in presence with other participants of the program
My son/daughter should always be in the presence of one of the organizers
My son/daughter has complete freedom to decide for his/her schedule, according to organizer’s rules

 

Please share with us your contact details in case of an emergency:

Name Surname Relationship to participant Telephone number
 

 

 

 

 

I have read and understood this document entirely. I understand and agree that my son/daughter can take part in this program.

 

PARENT’S NAME AND SURNAME:

_________________________________

ID NUMBER:

_________________________________

VENUE/DATE:

_________________/________________

SIGNATURE:

_________________________________