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
*
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Month
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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.
*
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Submit Application
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