Consent Form (minor) Delft 2014 14th National Selection Conference of EYP The Netherlands I, _________________________________________________________________________ (name of legal guardian), born on _____/______/19___ (date of birth) in _______________________________ (place of birth), hereby permit ___________________________________________________ (name of delegate) to participate in the 14th National Selection Conference of EYP The Netherlands in Delft (14 th – 17th February 2014) under the conditions outlined in the official Welcome Booklet. I acknowledge that in case of a violation of Dutch law during the event or the violation of our code of conduct (e.g. abuse of drugs or alcohol) my son/daughter will be excluded from the event and sent home at his/her own expense. Furthermore, I will cover any damage to public or private property that is caused by my son/daughter. I recognise that participation in physical activity involves the risk of injury to one’s person or property and acknowledge that by allowing my son/daughter to participate, I accept these potential risks. As part of the 14th National Selection Conference of EYP The Netherlands in Delft, 14th to the 17th of February 2014, I transfer the right to the picture of my son/daughter to the European Youth Parliament the Netherlands (Stichting Europees Jeugd Parlement Nederland) as well as any media present at the event, and give my consent to my son’s/daugther’s potentially being interviewed by journalists.
Signature: Place and date:
Telephone number of emergency contact:
Please return this form to academicprep@eyp.nl as soon as possible, but at the latest on Wednesday February 5th 23:59 CET.