Participant Information Form Unique Participant IDThis unique ID code can be found on your enrolment confirmation email.Participant Registration ID* Email address* Arrival TimeWe recommend that you arrive between 14:00 and 16:00 on the first Sunday of the programme, however registration will be open between 10:00 and 22:00 to accommodate international arrivals. Please note that accommodation is only available from 14:00 though you are welcome to leave your luggage with us if needed.If you are unable to arrive during the check-in period (10:00 - 22:00), please provide an estimated arrival time below. Pastoral InformationAll information is kept in the strictest confidence and shared with members of staff on a 'need to know' basis. Please complete this section with a parent or guardian.What are your preferred pronouns?*He/Him/HisShe/Her/HersThey/Them/TheirsIs your gender the same as the sex you were registered at birth?YesNoDo you have any dietary requirements?* None Vegetarian Vegan Pescetarian Dairy-free Gluten-free Religious - no beef Religious - halal Religious - no pork Religious - kosher Allergy Other Please provide details of your dietary requirementsDo you have any medical conditions we should be aware of?* Yes No Please provide details of your medical condition and any medications required.Immerse Education will distribute over-the-counter medicine if your child is unwell. Please check this box if you do not wish this to happen.Medicines to be distributed if needed: Paracetamol (for pain relief and fever reduction) Ibuprofen (for pain relief and fever reduction) Piriton (to relieve symptoms of mild allergies, such as hayfever) Strepsils (for sore throat relief) Simple Linctus (for mild coughs) Rennie (for heartburn and indigestion) Olbas Oil (decongestant for colds / congestion) Opt out Please provide any further information that you feel we should know before you attend the summer programmes with Immerse.For example, religious observance, days of absence, special requests etc.Primary Emergency Contact Name* First Last Primary Emergency Contact Number*Secondary Emergency Contact Name First Last Secondary Emergency Contact Number(optional)Your Postal Address*This will be used in the event that participants leave items behind or require resources to be posted to them after the programme. Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Academic InformationThe following information will be shared with your tutor in advance of the programme. It will not be used to assess, judge or set participants in any way.What school do you currently attend?* Please provide your school's website* What is your highest level of education and what grades did you receive?*Please outline your local education system. E.g. UK Education system, end of year exams (aged 13): Maths - B+ English - 75% Geography - 18/20What are your particular interests within your chosen subject?*What are your academic ambitions for the future?*What do you hope to gain by attending the Immerse summer programmes?*Programme policies*I, the participant, agree to abide by the Participant Code of Conduct as a condition of participation in the programme. I agree