Ffurflen Gofrestru /// Booking Form Cwrs Ieuenctid 2-4/11/18
Enw Llawn /// Full Name *
Your answer
Cyfeiriad /// Address *
Your answer
Dyddiad Geni /// Date of Birth *
Your answer
Ebost (os dros 13 oed) /// Email (if over 13 years old)
Your answer
Os nad ydych yn hapus i ni gysylltu gyda'ch plentyn yn electroneg plis ticiwch yma /// If you're not happy for us to contact your child electronically please tick the box
Enw yr Eglwys neu'r clwb chi'n mynd iddo (os yn berthnasol) /// Name of the Church or club you attend (if relevant)
Your answer
Enw Rhiant neu Gwarchodwr /// Name of Parent or Guardian *
Your answer
Rhifau Ffôn /// Phone Numbers *
Your answer
Ebost /// Email
Your answer
Rhif ffôn ag enw cyswllt ychwanegol /// Additional contact name and phone number *
Your answer
Enw, Cyfeiriad a Rhif Ffôn eich meddyg teulu /// Name, Address and Phone Number of family doctor *
Your answer
Manylion am unrhyw feddyginiaethau rheolaidd, problemau meddygol neu anabledd allai effeithio ar weithgaredd arferol neu ar weithgareddau allgyrsiol oddi ar y campws /// Information about any medication, medical problems or disabilities that may affect any usual activities or extra curricular activities off campus
Your answer
Nodwch os ydych angen unrhyw fwyd arbennig (e.e bwyd llysieuol) Nodwch hefyd manylion a difrifoldeb unrhyw alergedd bwyd /// Please note if you require any special food (e.g. vegetarian). Please also note the details and severity of any food allergies):
Your answer
Yr wyf yn rhoi caniatâd i fy mhlentyn fynychu a chymryd rhan yng ngweithgareddau arferol y cwrs ac y bydd yn cydymffurfio â rheolau Coleg y Bala yn ogystal ag unrhyw amodau a osodir gan y gweithgarwch allgyrsiol oddi ar y campws. (Mae rhestr o weithgareddau allgyrsiol ar gael ar gais.) Cytunaf ymhellach i unrhyw driniaeth feddygol frys y gellid bod ei angen. Rwyf yn deall, yn cydnabod ac yn derbyn y peryglon posib i fy mhlentyn wrth gymeryd rhan yn y digwyddiad /// I give permission for my child to take part in the usual activities of the course and to abide by the rules of Coleg y Bala and those of the extra curricular activities off campus. (A list of extra curricular activities are available on request.) I further agree to any emergency medical treatment that may be required. I fully understand, acknowledge and accept the risks involved in my child’s participation in the event. *
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