CDYS Online Activities Registration Form

CDYS Online Activities Registration Form

ALL Participants under the age of 18 are required to ask a Parent/Legal Guardian for permission to participate. Participant's aged 18 or over are to complete the form and sign the bottom of the form.
Participants Name *

First Name Last Name
Birth Date *

Day Month Year
Age *
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City County

Eircode
Phone Number *
Which Activities would you like to sign up for? *
I consent to allow photos to be taken of THE GROUP SCREEN for possible publication ON CDYS FACEBOOK PAGE and/or WEBSITE. *

Yes No
Parent/Guardian Name (if under 18 yrs)

First Name Last Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email Address
example@example.com
Parent/Guardian or Young Person over the age of 18. I give permission for CDYS Youth Workers to engage with the above named young person through online platforms. *

Clear
Should be Empty: