Application Form Your Name Your Phone Number Your Email Your Sex MaleFemale Your date of birth How many people travelling in your group Your Nationality Your Home Address Detail your other interests/hobbies Are you in good health YesNo Please provide details of any medical conditions, medications, allergies or dietary requirements Holiday Options: Please indicate your preference for one of the following Holiday dates Holiday 1 (Option 2 only): Arrive: Sun 21st June - Depart: Sun 28th June Holiday 2: Arrive: Sun 28th June - Depart: Sun 5th July Holiday 3: Arrive: Sun 5th July - Depart: Sun 12th July Holiday 4: Arrive: Sun 12th July - Depart: Sun 19th July Holiday 5: Arrive: Sun 19th July - Depart: Sun 26th July Holiday 6: Arrive: Sun 26th July - Depart: Sun 2nd August Holiday 7: Arrive: Sun 2nd August - Depart: Sun 9th August Holiday 8: Arrive: Sun 9th August - Depart: Sun 16th August Holiday 9: Arrive: Sun 16th August - Depart: Sun 23rd August Please select one of the following options: Option 1: English + Horse RidingOption 2: Horse Riding Camp Please select one of the following accomodation options: Option A: Stay with local Irish Host FamilyOption B: Stay at Lakelands Language Equestrian School Transport to/from Dublin Airport required Personal Details What is your level of English? Beginner - I don't understand English Elementary - I can say a few basic things in English Pre-intermediate - I can speak a little on most subjects Intermediate - I can understand conversations and speak well Upper Intermediate - I can speak confidently and quickly with a few mistakes Advanced - I speak fluently with very few mistakes For Horse Riders, which of the following are you competent at? Riding at walkTrotting with stirrupsTrotting without stirrupsCanteringCan Jump to 70cmCan jump above 80cm Your weight Your height Any additional information Important information: Emergency Contact Name Relationship to Student Emergency Phone number Emergency email Name of person making payment Where did you hear about us? Please tick to agree to our Terms & Conditions Please enter the characters you see: Please note that the information collected on this Application Form will be held in the strictest confidence and will not be shared with any third party. By submitting this Application Form you agree that your personal data can be processed by Lakelands Language Equestrian School for the purposes set out above. All of your information will be handled in accordance with General Data Protection Regulation (GDPR).