Homepage - Nordic Terrain Academy

Stavanger, Norway

Amsterdam, Netherlands

Camper First Name

Camper Last Name

Camper Age

Date of Birth

Gender

School Name

Parent First Name

Parent Last Name

Address

Email

Phone/Mobile

Name of Health Insurance Provider

Primary Physician

Physician Phone/Mobile

Please list any medical complications we should be aware of, including medications allergies (i.e. diabetic, asthmas, seizures)

Is your child recently being treated for an injury or illness or taking any form of medication for any reason

Yes

No

If yes, please explain

Is your child allergic to any type of food or medicaiton?

Yes

No

If yes, please explain

Does your child require a special diet?

Yes

No

If yes, please explain

I have read and agree to the NTA Terms and Conditions

A separate email will be sent with payment information

Confirm

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