Host Families - Registration Form

Contact Details:

Full Name*

First NameLast Name

Phone Number*

Another contact number*

E-mail*

example@example.com

Select your program?*

Would you like to host children, coaches or either?*

How many children could you host?*

What age would you prefer?*

Would you prefer to host a boy or a girl?*

How many coaches could you host?*

Let us know your preferences if needed

Are all the members of your family Irish and is English the language spoken in the house?*

Hosting address*

Street Address

Street Address Line 2

City

Eircode

How many adults (16 and up at the time of the program) will be interacting/living in the house with our student*

How many children (under 16 at the time of the program) will be interacting/living in the house with our student*

ADULT 1 - FULL NAME*

ADULT 1 - AGE*

ADULT 1 - GENDER*

ADULT 1 - ARE YOU GARDA VETTED?*

All members of the family aged 16 and up, living or interacting in any way with our students must be garda vetted before hosting.

ADULT 1 - PROFESSION*

ADULT 1 - NATIONALITY

Nationality if it's other than Irish

ADULT 1 - LANGUAGE

Language if it's other than english.

ADULT 2 - FULL NAME*

ADULT 2 - AGE*

ADULT 2 - GENDER*

ADULT 2 - ARE YOU GARDA VETTED?*

All members of the family aged 16 and up, living or interacting in any way with our students must be garda vetted before hosting.

ADULT 2 - PROFESSION*

ADULT 2 - NATIONALITY

Nationality if it's other than Irish

ADULT 2 - LANGUAGE

Language if it's other than english.

ADULT 3 - FULL NAME*

ADULT 3 - AGE*

ADULT 3 - GENDER*

ADULT 3 - ARE YOU GARDA VETTED?*

All members of the family aged 16 and up, living or interacting in any way with our students must be garda vetted before hosting.

ADULT 3 - PROFESSION*

ADULT 3 - NATIONALITY

Nationality if it's other than Irish

ADULT 3 - LANGUAGE

Language if it's other than english.

ADULT 4 - FULL NAME*

ADULT 4 - AGE*

ADULT 4 - GENDER*

ADULT 4 - ARE YOU GARDA VETTED?*

All members of the family aged 16 and up, living or interacting in any way with our students must be garda vetted before hosting.

ADULT 4 - PROFESSION*

ADULT 4 - NATIONALITY

Nationality if it's other than Irish

ADULT 4 - LANGUAGE

Language if it's other than english.

ADULT 5 - FULL NAME*

ADULT 5 - AGE*

ADULT 5 - GENDER*

ADULT 5 - ARE YOU GARDA VETTED?*

All members of the family aged 16 and up, living or interacting in any way with our students must be garda vetted before hosting.

ADULT 5 - PROFESSION*

ADULT 5 - NATIONALITY

Nationality if it's other than Irish

ADULT 5 - LANGUAGE

Language if it's other than english.

CHILD 1 - FULL NAME*

CHILD 1 - GENDER*

CHILD 1 - AGE AT THE TIME OF THE PROGRAM*

CHILD 1 - DATE OF BIRTH*

Fecha

CHILD 1 - IS THIS CHILD ATTENDING THE PROGRAM?*

CHILD 1 - NATIONALITY

Nationality if it's other than Irish

CHILD 1 - LANGUAGE

Language if it's other than english.

CHILD 2 - FULL NAME*

CHILD 2 - GENDER*

CHILD 2 - AGE AT THE TIME OF THE PROGRAM*

CHILD 2 - DATE OF BIRTH*

Fecha

CHILD 2 - IS THIS CHILD ATTENDING THE PROGRAM?*

CHILD 2 - NATIONALITY

Nationality if it's other than Irish

CHILD 2 - LANGUAGE

Language if it's other than english.

CHILD 3 - FULL NAME*

CHILD 3 - GENDER*

CHILD 3 - AGE AT THE TIME OF THE PROGRAM*

CHILD 3 - DATE OF BIRTH*

Fecha

CHILD 3 - IS THIS CHILD ATTENDING THE PROGRAM?*

CHILD 3 - NATIONALITY

Nationality if it's other than Irish

CHILD 3 - LANGUAGE

Language if it's other than english.

CHILD 4 - FULL NAME*

CHILD 4 - GENDER*

CHILD 4 - AGE AT THE TIME OF THE PROGRAM*

CHILD 4 - DATE OF BIRTH*

Fecha

CHILD 4 - IS THIS CHILD ATTENDING THE PROGRAM?*

CHILD 4 - NATIONALITY

Nationality if it's other than Irish

CHILD 4 - LANGUAGE

Language if it's other than english.

CHILD 5 - FULL NAME*

CHILD 5 - GENDER*

CHILD 5 - AGE AT THE TIME OF THE PROGRAM*

CHILD 5 - DATE OF BIRTH*

Fecha

CHILD 5 - IS THIS CHILD ATTENDING THE PROGRAM?*

CHILD 5 - NATIONALITY

Nationality if it's other than Irish

CHILD 5 - LANGUAGE

Language if it's other than english.

Do you have any dogs living in the house?*

Are any of your dogs considered as a RESTRICTED BREED IN IRELAND?*

Do you have cats living in the house?*

Do you have any other pets in the house?*

Tell us more information if needed:

How did you hear about us?*

Could you please send us a few quality pictures of the house, garden, kid's room, kitchen? 4-5 photos is enough. Please add garda vetting documents if you already have them. If you don't have the pictures or the documents at this moment you can send them in the coming days.

Host Families - Registration Form

FAMILY MEMBERS LIVING IN THE HOUSE

PETS AT HOME