Youth Mix February 2026

Join us for a great weekend of friendship, fun and Bible Teaching! Open to all 14-18 year olds. Early booking is advised.

Dates: 13 - 15 November 2026

Venue: The Faith Mission Centre, Durrow, R32 HX23

Cost: €60

Arrival: Friday at 8.00pm, Finish on Sunday at 3.00pm.

For more information, contact:
James & Katie Brown, midlands.irish@faithmission.org
Booking Form
Young Person's Name

First NameLast Name
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Age at Youth Mix
Birth Sex
Address

Street Address

Street Address Line 2

CityCounty

Eircode
Parent's Mobile Number
Email

Confirmation Emailexample@example.com
Name, Address and Telephone number of your G.P.
Emergency contact name and mobile number
Does your young person require regular medication?
If "Yes" please specify
Does your young person suffer from:
If any of the above are ticked, then please give details.
Has your young person been vaccinated against Tetanus?
If "Yes" please give date of most recent booster
Has your young person had any other serious illness in the past of which we should be aware of?
Have you any other information about your son/daughter’s health, social or learning abilities which you think we should know?
If the need arises are you happy for our First Aider to administer Paracetamol at the recommended dosage?
CONSENT: I certify that my son/daughter is physically fit to take part in the activities. I understand that those attending the Youthmix may go shopping with other young people without supervision. Should it be necessary, I give my consent for my son/daughter to have emergency hospital treatment and understand that I will be notified as soon as possible. I am aware that video and photos may be taken during the event which may be used in future publicity purposes.
Parent's/Guardian's Name

First NameLast Name
Parent's Signature (under 18s)
cost
YouthMix Cost

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EUR

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Booking Form

YouthMix Cost

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