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2010 Online Application
for Summer Camp
To apply for summer camp, students need be aged between 7-25 (on arrival). For students under 16, following application should be submitted by parent or guardian.  Application needs to be submitted at least 6 weeks before intended start date. Late applicants are accepted on case to case basis.
Make sure you have read Price & Schedule. If you prefer, you can print and send the PDF application form by email or fax.
Program Data
Program you’d like to apply for*
Day Camp (7-15yrs)
Full Camp (7-25yrs)
Accompanying parents (only refer to parents that pay parent fee and join the camp)
None Yes (number of accompanying parents)
 
Start Date*   Guide
June 14
June 28
July 12
July 26
August 09
Others
Duration*   Guide
weeks
Airport Pick-up  Guide
No Yes
Arrival Date
Coming from (City) Airport of Arrival
Airline Flight No
Arrival Time    
Student 1 Information
Personal Information
First Name* Family Name*
Gender* Male Female
Nationality* Native language*
Date of Birth* day month year
Tel No.*
Country Area Phone
Mobile No.
Country Area Phone
Address*
(street) (city)
(zip code) (country)
Company/School
Occupation/Grade
Website
Passport Number
(Provide as soon as possible if you don’t have one yet)
Current level of Chinese*
Total Beginner Beginner Elementary
Pre-intermediate Intermediate Advanced
Health Condition*
Any medical conditions(Allergies, asthma, illnesses, previous injuries, disabilities)
None Yes
(please specify here)
Symptoms Medications
Emergency Contact
Name* Relationship*
Tel No.*
Country Area Phone
Mobile No.
Country Area Phone
Taken any programs with Mandarinrocks before?*
None Yes
(please specify here)
How did you hear about us? Please specify here*
Yahoo Search Google Search
Advertisement
Friend
Agent
Company
Student 2 Information       Skip this if there are no more students
Personal Information
First Name Family Name
Gender Male Female
Nationality Native language
Date of Birth day month year
Tel No.
Country Area Phone
Mobile No.
Country Area Phone
Address
(street) (city)
(zip code) (country)
Company/School
Occupation/Grade
Website
Passport Number
(Provide as soon as possible if you don’t have one yet)
Current level of Chinese
Total Beginner Beginner Elementary
Pre-intermediate Intermediate Advanced
Health Condition
Any medical conditions(Allergies, asthma, illnesses, previous injuries, disabilities)
None Yes
(please specify here)
Symptoms Medications
Taken any programs with Mandarinrocks before?
None Yes
(please specify here)
Student 3 Information       Skip this if there are no more students
Personal Information
First Name Family Name
Gender Male Female
Nationality Native language
Date of Birth day month year
Tel No.
Country Area Phone
Mobile No.
Country Area Phone
Address
(street) (city)
(zip code) (country)
Company/School
Occupation/Grade
Website
Passport Number
(Provide as soon as possible if you don’t have one yet)
Current level of Chinese
Total Beginner Beginner Elementary
Pre-intermediate Intermediate Advanced
Health Condition
Any medical conditions(Allergies, asthma, illnesses, previous injuries, disabilities)
None Yes
(please specify here)
Symptoms Medications
Taken any programs with Mandarinrocks before?
None Yes
(please specify here)
Family Information
Parent 1/Guardian 1
Name* Relationship*
Nationality* Age*
Occupation*    
Tel No.*
Country Area Phone
Mobile No.
Country Area Phone
Accompanying parent? (only refer to parents that pay parent fee and join the camp)*
No Yes
Parent 2 / Guardian 2
Name Relationship
Nationality Age
Occupation    
Tel No.
Country Area Phone
Mobile No.
Country Area Phone
Accompanying parent? (only refer to parents that pay parent fee and join the camp)
No Yes
Address*
Same as Student 1
Yes No
(street) (city)
(zip code) (country)
Payment
To confirm your booking, a deposit of 240USD/180EUR for each student and each accompanying parent deductable from the total (NON REFUNDABLE) must be paid to MandarinRocks. This deposit is not an additional cost. The balance must be paid at least 6 weeks before arrival. Students currently in Shanghai can pay by credit card or cash in person at school. Students from other cities or abroad can only pay by bank transfer. We will contact you with a confirmation email within the next 48 hour after your application is submitted. The deposit and payment is payable at that point, not now.
Other Information You Need Us to Know
Special Permission (For students under 16 only)
We give permission for our kids to leave the camp unsupervised (within MandarinRocks’ regulations)   Guide
Yes No
Verify Email Address
All current and future correspondence, including confirmations and updates, will be sent to this address.
Enter your email address
Re-enter your email address
Email me occasional promotions and new offers
   
I have read and agree to Mandarinrocks’ Summer Camp Terms and Conditions
Contact Details
MandarinRocks (Shanghai)
Tel +86 21 62550715
Fax +86 21 62883988
E-mail: info@mandarinrocks.com
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