Llanfyllin Youth Arts Cafe - Arts Connection

Youth Arts Cafe | Llanfyllin | Caffi Celf Ieunectid

Young Person First Name | Enw Cyntaf Person Ifanc

Young Person Surname | Enw Cyntaf Person Ifanc

Date of Birth | Dyddiad Geni

Address | Cyfeiriad

Young Person Email | Ebost Person Ifanc

Young Person Phone | Ffôn Person Ifancmobile | ffôn symudol

Parent / Carer First Name | Rhiant / Gofalwr Enw Cyntaf

Parent / Carer Surname | Rhiant / Gofalwr Cyfenw

Parent / Carer Email | Rhiant / Gofalwr Ebost

Parent / Carer Phone | Rhiant / Gofalwr Ffônmobile or landline // ffôn symudol neu linell dir

Can we add your number to a parents / carers WhatsApp group? | A allwn ni ychwanegu eich rhif at grŵp WhatsApp rhieni/gofalwyr?

Yes | OesNo | Nac Ydw

I consent to any emergency medical treatment required by my child should they need it | A allwn ni ychwanegu eich rhif at grŵp WhatsApp rhieni/gofalwyr?

Yes | OesNo | Nac Ydw

I would like to volunteer occassionally at the youth cafe | Hoffwn wirfoddoli yn achlysurol yn y caffi ieuenctid

Yes | OesNo | Nac Ydw

Alternative Parent / Carer Phone | Rhiant / Gofalwr amgen Ffônmobile or landline | ffôn symudol neu linell dir

Young Person - any medical conditions (i.e. allegies, epilepsy, asthma, diabetes, travel sickness etc.) and / or dietry needs? How will they be getting home? Any other info? | Person Ifanc - unrhyw gyflyrau meddygol (h.y. alergeddau, epilepsi, asthma, diabetes, salwch teithio ac ati) a / neu anghenion dietegol? Sut fyddan nhw'n cyrraedd adref? Unrhyw wybodaeth arall?

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I am happy for the young person to: | Rwy’n hapus i’r person ifanc:

Walk home | Cerdded adref Leave during the session | Gadael yn ystod y sesiwn I have asked them not to leave the Youth Club | Rwyf wedi gofyn iddynt beidio â gadael y Clwb Ieuenctid

I agree that any photos, film, music or art works made by me or of me and the above-mentioned people produced through this project can be used by Arts Connection to promote their participatory arts activities. Please tick which you are happy with // Rwy'n cytuno y gall unrhyw luniau, ffilm, cerddoriaeth neu weithiau celf a wnaed gennyf i neu gennyf i a'r bobl uchod a gynhyrchwyd trwy'r prosiect hwn gael eu defnyddio gan Arts Connection i hyrwyddo eu gweithgareddau celfyddydau cyfranogol. Ticiwch pa rai rydych chi'n hapus â nhw:

Yes | OesNo | Dim

I agree to the terms as set out in the Arts Connection - Cyswllt Celf Privacy Policy // Cytunaf â'r telerau a nodir yng Nghynllun Cyswllt Celfyddydau - Cyswllt Celf

Please Tick | Ticiwch, Diolch