Mandatory Attachments

Accepted formats: JPG, JPEG, PNG, PDF. Maximum size: 5MB

Passport Photo (mandatory in JPG/JPEG format) *

Copy of Passport, Identity Card (ID) or CNI *

Scan of Visa (if applicable)

I. Applicant's Basic Data

First Name *
Last Name / Surname *

Gender *
MF

Date of Birth *

Address *
City *
Province / State *
Postal / Zip Code *
Country of Origin *

Email *
Landline Phone
Mobile Phone *

Nationality *
Passport / ID / CNI Number *
Issued by *
Valid until *

Weight (kg)
Height (cm)
T-shirt Size * SMLXLXXL

Have you already participated in our Camp? *
YesNo

If yes, when and where?

Hobbies & other interests
English Proficiency * GoodFairNone
Other spoken languages

II. Additional Data (Health and Dietary)

Disabilities

Wheelchair?
YesNo

Electric wheelchair?
YesNo

Folding wheelchair?
YesNo

Crutches?
YesNo

Able to participate in sports activities?
YesNo

Can you swim?
YesNo

Do you smoke?
YesNo

Dietary Preferences No specific dietVegetarianVegan
Medical/religious/dietary requirements or Allergies
Medications to take (and frequency)

Do you suffer from incontinence?
YesNo

Anything else to report

Attending Physician Details

Physician's Name
Physician's Email
Physician's Phone

III. Family Data (In case of emergency)

Name of responsible Parent or Guardian *

Is a Lion member?
YesNo

Full Address *
Landline Phone
Mobile Phone (Emergency Contact) *
Emergency Email *

IV. Chaperone Data *

Chaperone's Full Name *
Chaperone T-shirt Size * SMLXLXXL

Is a Lion member?
YesNo

Chaperone's Address
Phone / Mobile
Chaperone's Email

V. Lions Multidistrict / District (Sponsor) Data

District D or MD Nr.
Lions Club Name
Email
Phone/Mobile

VI. Agreements and GDPR Information

If admitted to the program, I declare that I am aware of the rules: prolonged personal travel is not allowed, participation is not for tourism purposes, and I cannot drive motor vehicles. Any violation may result in the immediate termination of the visit at my own expense. I also commit to covering any unforeseen expenses not included in the program.

(For Parents/Guardians) We agree to release any Lions member or Club from financial liability in the event of illness, accidents, or other emergencies. We guarantee that the participant will return home at the end of the camp and is equipped with suitable insurance for repatriation and medical expenses. We consent to any emergency medical treatments.

I authorize the use of photos and videos taken during the program for the creation of material published on social media or for promotional purposes.

I have read the privacy policy (GDPR REG 679/2016). I consent to my personal data, including identity documents and health/insurance data, being processed and stored by the Lions responsible for the organization and management of the Lions Leo Youth Camp.

Acceptance Signatures

By entering their Name and Surname in the fields below, the parties affix their digital and electronic signature confirming all entered data and accepted regulations.

Participant's Signature (Name and Surname) *
Parent/Guardian's Signature (Name and Surname) *
Chaperone's Signature (If applicable)
Date of compilation *