Global Development Begins with YOUth - Parental/Guardian Consent

Young Person’s Name: (required)

DOB: (required)

Address: (required)

Gender: (required)

Parent/ Guardian Name: (required)

Parent/Guardian Contact No.: (required)

Nominated emergency contact person name: (required)

Nominated emergency contact person number: (required)

Does your child have any allergies or medical conditions (incl eczema & asthma)? Please state: (required)

Does your child have any specific dietary/cultural requirements? Please, state: (required)

11. I/we give permission to the management of Ballyhoura Development CLG to act on my behalf in case of emergency/accident and to take such action as may be necessary for the benefit of my child. This decision is to be taken by the staff person in charge (required)

YesNo

I/we give permission for contact via phone call/ text message/ flyer by Ballyhoura Development CLG staff (required)

YesNo

I/we give permission to take photographs for use on BD social media platforms. (required)

YesNo

Your full name: (required)

Date: (required)