LEMANIA SUMMER CAMP APPLICATION FORM SWITZERLAND

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Ecole Lémania Fondée en 1908 LEMANIA SUMMER CAMP APPLICATION FORM 2018 - SWITZERLAND ECOLE LEMANIA Chemin de Préville 3 1003 Lausanne Switzerland Tel +41 (0) 21 320 15 01 info@summercamp.ch www.summercamp.ch

Grindelwald 1. General information Student Male Female Surname... Date of birth... First name... Nationality... Passport number (enclose a copy of the passport if you need a visa)... Do you need a visa to study in Switzerland? Yes No Address (Street, No.)... Post code / Town or city... E-mail (mandatory)... Country... Mobile no. (for activities)... Parents / guardians Surname... First name... Address (Street, No.)... Post code / Town or city... Mobile no. (mother)... Telephone (home)... Country... Mobile no. (father)... Telephone (work)... E-mail... Address for invoice and confirmation letter (if different from parents address) Agent name... Name / First name of responsible person... Address (Street, No.)... Post code / Town or city... Country... Telephone... 1

Choice of programme (please refer to the pricelist) Boarder Day student Enrolment fee, CHF 150.- Choose 2 weeks, 3 weeks, 4 weeks or more from June 24 th to August 11 th 2018 : Chosen Dates... From... To... (students may enrol for both July and / or August, new intake Sunday / Monday) Intensive Programme / 15 hours... Intensive Plus Programme / 20 hours... Intensive Programme / 15 hours... Intensive Plus Programme / 20 hours... IELTS Programme / 20 hours... French French English English English Do you want to follow our regular intensive language courses after August 12 th? yes no Shared room (Two twin beds)... Comfort + Comfort Standard Single room... Comfort + Comfort Standard Early booking is recommended as there is a limited number of boarding places. Boarders must arrive on Sunday afternoon and leave on Saturday morning. Key deposit 2. Accommodation Boarding school (please refer to the price list, if boarder) Students must pay a deposit for their room key upon arrival. This amount will be refunded when the key is returned on their departure. There will be no refund if the key is lost. Choice of deposit currency... CHF 100.- 100 100 US$ Remarks / Agent name... 2

3. Optional services Private language tuition : 130 CHF per hour English French If you would like private tuition, please specify the number of lessons required per week :... One-way pick-up by a school staff (train or car) only on sunday from 10 a.m. to 6 p.m. : from to Geneva airport, CHF 125.- One-way Limousine shuttle service at anytime : from to Geneva airport, CHF 270.- Zurich airport, CHF 970.- Return Limousine shuttle service at anytime : Geneva airport, CHF 540.- Zurich airport, CHF1940.- Group s transfer (minimum 7 students) : Return Geneva airport, CHF 75.- / student Visa, invoice or confirmation letter sent by express mail: CHF 120.- N.B. : Foreign (non-eu) students will need a visa. It takes at least 7 working days to send this visa from Switzerland to foreign countries by normal mail (free of charge). Please bear in mind the time required to obtain the visa. We must receive your enrolment application and payment at least 3 weeks before your arrival date for the summer programme. For boarding students only : pocket money held in safe-keeping Would you like to send additional pocket money for your child? Yes No If so, amount in CHF... The school will keep this money in a safe and give the required amount to the child if necessary. For day students only 5 lunches per week for external students: CHF 90.- per week Activity pack for external students : 6 activities from Monday to Saturday afternoons CHF 350.- (including insurance) Optional health insurance : CHF 50.- / week N.B. : All activities and meals are included for boarders. 3

4. Medical and dietary information Does the student have any health problems or any specific disabilities that we should be aware of? Does he or she require treatment or a specific diet? Yes No If so please specify... Does the student suffer from any allergies? Yes No If so please specify... Does the student need to take any specific medication/have specific treatment? Yes No If so please specify (with dosage)... Other... 5. Flight information, if already known, for the airport shuttle service Name of airline... Arrival airport... Geneva Zurich Arrival date...flight number...arrival time... Departure date...flight number...departure time... Please send to info@summercamp.ch these flight details at least 3 weeks before the student s arrival 4

6. Payment methods Enrolment becomes legally binding once Lemania has sent written confirmation of acceptance and received payment in full. N.B. : The reservation is only secure once the invoice has been paid in full. We recommend that you make the payment immediately after sending the registration form to secure a room in the boarding school, otherwise a room may no longer be available. Any refunds of payments made by credit card will be made to the same credit card. Bank wire transfer (Please put the student s surname and first name as the payment reference) Bank transfer to : Ecole Lemania, Chemin de Préville 3, 1003 Lausanne, Switzerland Please choose one of the following bank accounts Account Swift code Clearing code and account number IBAN UBS SA, Lausanne 243 285.400.01J UBSWCHZH80A 243 285.400.01J CH20 0024 3243 285 40001 J Crédit Suisse, CS Lausanne BCV, Banque Cantonale Vaudoise, Lausanne 4425 481.715-01J CRESCHZZ10A 425 481.715-01J CH11 0483 5048 1715 0100 0 767 302.09.50 BCVLCH2L 767 302.09.50 CH30 0076 7000 E030 2095 0 Paypal (we charge 3% more) If you would like to pay through Paypal.com, please choose as beneficiary : info@summercamp.ch Credit card (we charge 3% more, the amount will be debited immediately) please choose the type of card Mastercard Visa American express Diners and fill in the following information Card no... Expiry date... Surname and first name of the card holder as shown on the card... Signature of the card holder... Direct payment I am a Swiss resident and would like to pay directly at the secretarial department of Lemania School, Chemin de Préville 3, in Lausanne, no later than four weeks before the start of the Summer Programme. I will pay... in cash by credit card (3% more) 5

7. Background information Have you previously studied at Ecole Lemania? Yes No If so, in what year?... Why did you choose Lemania Summer Camp?... How did you hear of Lemania Summer Camp? Relatives or acquaintances Former students Word-of-mouth Direct mail advertising Advertising flyer Exhibition/Fair Lemania Summer Camp website Google Facebook, Twitter, Linkedin Agent... Lemania representative (name)... Swiss Embassy / Consulate (Town or city, country)... Newspaper / magazine (please specify)... Advertisement (please specify)... Other (please specify)... 6

GENERAL CONDITIONS 1. Enrolment fee The non-refundable enrolment fee only applies to new students. It covers processing charges and will be kept in the event of a cancellation. 2. Health insurance The parents (or guardians) are required to notify Ecole Lemania in writing of any health and medical information, or useful information, such as previous studies and favourite pastimes, so that the school may take appropriate action where necessary. Health insurance is compulsory in Switzerland. Boarding students that are not Swiss residents must be insured through the school. Premiums must be paid by the parents/legal guardians or by the student and are already included on the boarder s programme prices. Day students are not insured by the school but must have personal health insurance that is valid in Switzerland, the EU and the rest of the world. The school cannot, under any circumstances, be held responsible for any negligence regarding the student s health insurance situation. 3. Accident insurance The school provides accident insurance for all students, who are covered on the direct journey to and from Ecole Lemania and during activities organised by the school, provided that the student has taken out health insurance, which must be valid in Switzerland, the EU and the rest of the world. 4. Premature departure and cancellation of enrolment Written notice must be provided for the departure of a student prior to the end of the programme on which he or she is enrolled. No refunds shall be given in the event of the premature departure, exclusion of the student, or cancellation within 30 days of the start of the course and after the start of the courses. 5. Student rules and student behaviour The student must comply with all of the school and boarding school rules. The use or possession (even briefly) of alcohol or illegal substances is strictly forbidden and may lead to immediate exclusion. The students are expected to behave properly and protect the school s reputation by acting as its ambassadors. However, Ecole Lemania reserves the right to terminate the course or boarding of any student whose behaviour is deemed by the school to be unacceptable. In that case, no refund will be made. 6. Right of reproduction Copyright Ecole Lemania and Lemania Summer Camp reserves the right to use any photos, films or videos of the students free of charge for any publications or broadcasts on the Internet/TV, in brochures, newspapers or magazines, and on posters /signs or websites, on public or private places, etc. 7. Payment methods Payments are accepted through Paypal, bank wire transfer and credit card. In the latter case, any refunds will be made by credit card. 3% surcharge if payment by paypal or credit card. 8. Third-party liability insurance Parents or responsible persons are strongly recommended to take out third-party liability insurance, as they will otherwise be held personally responsible for any damage caused by the student. 9. Pocket money Parents may send an additional amount of money for students attending the summer camp. The school will keep this money in a safe and give the required amount to the student if needed. 10. Extra expenses/charges/medical and damages Ecole Lemania can invoice outstanding fees for amounts due for medical or hospital care/products or tablets/services not covered by health insurance, pocket money, extra activities, extra expenses, extra charges, exchange rate charges, damages to rooms or facilities, etc. 11. Food allergies The school cannot guarantee the provision of allergen-free food. In the case of food allergies, Ecole Lemania and its staff can not be held responsible for allergies caused by certain products. Any of the food served at school or provided during activities/sports/trips could include allergenic components, and the student must take personal responsibility for checking what he or she eats and for informing the staff. 12. IELTS test The school offers a very good IELTS test preparation. However, the school cannot guarantee a minimum of points for the IELTS test and decline any responsibility for the results. The student must work strongly and regularly during the programme to obtain the desired IELTS test level. The test takes place in Lausanne. In case it is held another city, the school will charge the night of the hotel and the train. 13. Programmes In the case of insufficient applicants for any programme, the school will offer to the student another equivalent programme, or in some exceptional case, cancel the programme and refund the client. Ecole Lemania reserves the right to modify the date, time and location of the lessons, and to cancel or postpone a lesson or activity if the number of enrolments is insufficient. It may also divide classes in two if there are too many enrolments. In the event of the cancellation of a course by the school, any amounts already paid will be refunded. 14. Unenforceability of Provision If any provision of this Agreement, or any portion thereof, is held to be invalid and unenforceable, the remainder of this Agreement shall nevertheless remain in full force and effect. 15. Contract law Any disputes will be brought before the court of appeal in Lausanne, Switzerland. Parents, guardians or representatives waive their right to initiate legal proceedings in their own country. However, Ecole Lémania (Chemin de Préville 3, 1003 Lausanne, Switzerland) also retains the right to institute legal proceedings in the country of jurisdiction of any parties concerned. Contracts entered into with parents, guardians, representatives or students are subject to Swiss Law. Signature of Parents / Legal Guardian / Agent I have read, understood and signed the General and Financial Conditions, the Cancellation Policy and/or premature departure policy. Signature : Place / Date... Surname / First name... 7