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Consent Form (Minor)
Rotterdam 2015: 15th National Selection Conference of EYP the Netherlands I, _________________________ (name of legal guardian), born on _____/______/______ (date of birth) in _______________________________ (place of birth), hereby permit ____ _______________________________________________ (name of delegate) to participate in the 15th National Selection Conference of EYP The Netherlands in Rotterdam (6th – 9th February 2015) 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 15th National Selection Conference of EYP The Netherlands in Rotterdam, 6th to the 9th of February 2015, 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. Place and date:
Signature:
Telephone number of emergency contact:
Please return this form to nationals@eyp.nl as soon as possible, but at the latest on Wednesday January 21st 23:59 CET.