To Konstantin Fedorenko Director International Child Centre «Artek» ______full name of the parent or legal representative ______residential address Tel.: ______

Email: ______

APPLICATION I,______, full name of the parent or legal representative Passport No.______, issued on______by ______date and issuing authority ______for adoptive parents/legal representatives, include details of adoption/custody document ______residential address give my consent for my daughter/son ______child’s full name to participate in the following activities: Activities approve do not approve Educational and training events at the International Child Centre «Artek» within Artek’s approved educational program Extracurricular physical fitness and sports activities, events and competitions that require extra physical exercise, including: Clubs (boating, sailing, sports, touring, climbing, etc.); Sports clubs and training Horseback riding Team and individual competitions (football, basketball, volleyball, tennis, table tennis, golf, miniature golf, water polo, laser tag, paintball, etc.) Cyclic sports (track and field, running, rowing, jumping, swimming, diving, etc.) Highly coordinated sports (aerobics, artistic and rhythmic , cheerleading, kayaking, , wind surfing, artistic cycling, speed roller-skating, rock climbing, mountaineering, parkour, diving, etc.) Endurance sports (arm wrestling, power lifting, fitness, yoga, etc.) Martial arts (sambo, aikido, wrestling, judo, , etc.) Multiathlons (, track and field multiathlon, etc.) Air sports (, aeronautics, sky surfing) Extracurricular touristic and local history activities requiring physical endurance and strength, including: Hiking, including camping (the Krinichka and Dubrava tourist camps, cross-country hiking), extreme hiking (caves), trip to Ayu-Dag. Touristic competitions (test routes), Turgrad Rock climbing and ropes course Swimming (in a pool or in the sea), seaside and marine festivals and competitions Motor boating, boating, pedalo riding (including boat excursions) Tours and visits to cultural and historical landmarks in Crimea and Sevastopol City Stay in an accommodation with bunkbeds, sleeping on the upper bed

My child has no conditions preventing him\her from participating in the above-stated activities I give my consent to my daughter/son to:

______, 20___ signature full name of the parent/legal representative date