LYCC Members Return to Youth Club Form
This form should be filled in by a Parent or Guardian if your child is already a member of our youth club.
Before we welcome our young people back to LYCC Youth Club sessions, we need to make sure we have all the correct up to date contact details, school/teacher details, medical info (allergies) and if your child is in an at-risk group for Covid, and any additional needs info that could help us.
We require this information for the safety of all of our young people.
We also need parents to read the Youth Club Code of Behaviour and updated rules and make your child aware of its contents.
You only need to fill out this information ONCE, and we will then update our database.
If you have more than one child in the Youth Club, please fill out this form for each child.
Many thanks for your input. LYCC Youth Club Team
Name and surname of the Youth Club member
What school does your child attend?
Scoil San Carlo Senior School
Scoil Eoin Phoil
Scoil Ui Dhalaigh
What class/year is your child currently in?
5th Class (Primary)
6th Class (Primary)
1st Year (Secondary)
2nd Year (Secondary)
3rd Year (Secondary)
Primary students - what is the name of your child's teacher?
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This form was created inside of Leixlip Youth and Community Centre.