ࡱ> #`bjbjmmJJJJ***>84,>.JJJJJ-------$/h2-*d@-JJJJ6-"""JJ*J-"-""%@*!&J> =b%--0.%,2F!T2!&2*!&`"--"^.>>>">>>">>>JJJJJJ  Totes les activitats destiu que formen part del fullet informatiu editat per lAjuntament de Vilanova i la Geltr han de garantir la inclusi de tots els infants i adolescents sense cap tipus de discriminaci. Lentitat organitzadora de lactivitat destiu pot sollicitar a lAjuntament de Vilanova i la Geltr el refor de lequip de monitors/es per atendre aquells participants que presenten especials dificultats dintegraci (discapacitat psquica, fsica o sensorial). El requisit imprescindible per poder sollicitar el refor a lequip de monitors/es s que linfant/ adolescent estigui empadronat a Vilanova i la Geltr.      NOM I COGNOMS DE LINFANT/ ADOLESCENT: DATA DE NAIXEMENT: TIPOLOGIA: Fsica Auditiva Visual Psquica Mental CENTRE EDUCATIU ON ESTUDIA: PROFESSIONAL DE REFERNCIA i TUTOR-A: NOM DEL PARE: TELFON: NOM DEL MARE: TELFON:  Nota: Pel bon funcionament de lactivitat destiu, es far un recompte del total dinscrits/es amb discapacitat en una mateixa activitat per valorar ladequaci del nombre total en el grup i en lactivitat destiu.     rea de Serveis a les Persones Regidoria de Serveis Socials  C. del Marquesat de Marianao, 2 08800 Vilanova i la Geltr 93 814 00 00 Ext. 3420 www.vilanova.cat  Fitxa per sollicitar la valoraci de necessitats de suport durant lactivitat destiu Autoritzaci per sollicitar informaci al centre educatiu Dacord amb la llei 15/1999, de protecci de dades de carcter personal, linformem que les dades recollides en aquesta autoritzaci seran nica i exclusivament utilitzades per valorar ladequaci de lactivitat destiu amb les caracterstiques de linfant/ adolescent aix com la valoraci dun monitor/a de suport, si sescau, en lactivitat. El sotasignant autoritza que les dades de nom i cognoms del fill/a puguin utilitzar-se per a fer la consulta entre lAjuntament de Vilanova i la Geltr i el centre educatiu on estudia el seu fill/a aix com entre Ajuntament de Vilanova i la Geltr i lequip psicopedaggic del centre per valorar la necessitat dun suport total, parcial o assessorament a lequip de monitors/es de lactivitat destiu on sha inscrit. Signatura del pare/mare/ tutor Data: _____________ A omplir per lentitat organitzadora de lactivitat destiu Nom de lactivitat destiu: ___________________________________ Entitat que gestiona lactivitat destiu: _________________________ Persona de contacte de lentitat: ______________________ Telfon i correu electrnic: ________ Setmanes que sinscriu linfant/ adolescent: __________________________________________________________________ * el suport que ofereix lAjuntament s dun perode de mxim 4 setmanes Utilitzaci menjador: s no Existncia de barreres arquitectniques a lequipament: s no Programaci de sortides i excursions: s no Hi ha activitats especfiques a lactivitat destiu que requereixin especial suport? : s no Quines? ____________________________________________ ay~ x " = | } ~  źŲŲŲźŲźŲźźźŤxtkhe~5CJaJhe~"jh zUmHnHsH tH ujh zUmHnHuh4vh?2h_kjhe~UmHnHuhECJaJhn!hn!CJaJhn!h_kCJaJh zCJaJhC5DhC5DB*phhC5Dhc B*phhedjhK6UmHnHu)~ gd4v$a$gdn!$a$gd_k  + O | } ! 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