REGISTER

In order for a child (young person under 18 years) to participate in the youth service we require that their parent/guardian provide us with consent and some key details for our records.

There is no charge for registration

Parent's Details

Parent/Guardians name(s)*

Parent/Guardian phone number*

Parent's Email Address*

Address

Street Address Address Line 2 City County Eircode

Child's Details

Young person/ child’s name*

Age

Date of birth*

Child's contact Email Address

Child's contact phone number

Youth Centre*

Please note any medical conditions or allergies that your child has and that you feel we should be aware of?

Consent

Medical Treatment Consent

I agree to give consent for emergency medical treatment if I cannot be contacted

In the case of an emergency, Sphere 17 staff will do everything possible to contact the parent/guardian.

However, in the event that contact cannot be made, I authorise the certified first aid responder and/or leader in charge to give consent for any medical treatment on my/our behalf.

Photograph/Video Footage Consent

I agree to give consent for Photograph/Video Footage Usage

Photographs and video footage are used to document, promote and celebrate young people’s participation in activities here in Sphere 17. This includes putting photos and video footage onto our social media pages/website (www.sphere17.ie)
Please indicate if you agree/disagree for photos/footage of your child to be used in this way.

Activities Consent

I hereby give my consent for my child to participate in activities* with Sphere 17 Regional Youth Service.

* Please note that where activities are planned for outside of the youth centre or community, notification will be provided and written consent from parents/carers will be requested in advance. Parents/carers will also be contacted when we have information to share or if we have any concerns about a young person.

Sphere 17 RYS processes personal data in line with GDPR regulations. For more information please see our Privacy Notice on http://www.sphere17.ie/policies-and-forms/

Comments

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REGISTER

Parent's Details

Child's Details

Consent

CONTACT

LOCATIONS

Sphere 17 – Darndale

Sphere 17 – Bonnybrook

Sphere 17 – Kilbarrack

Sphere 17 – Priorswood