Ffurflen Gofrestru /// Booking Form               CIC Blaenau
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Enw Llawn /// Full Name *
Cyfeiriad a Chôd Post /// Address and Post Code *
Dyddiad Geni /// Date of Birth *
Enw Rhiant neu Gwarchodwr /// Name of Parent or Guardian *
Rhifau Ffôn /// Phone Numbers *
Ebost /// Email
Rhif ffôn ag enw cyswllt ychwanegol /// Additional contact name and phone number *
Enw, Cyfeiriad a Rhif Ffôn eich meddyg teulu /// Name, Address and Phone Number of family doctor *
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
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):
Yr wyf yn rhoi caniatâd i fy mhlentyn ddod a chymryd rhan yng ngweithgareddau arferol CIC ac y bydd yn cydymffurfio â rheolau. 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 CIC and to abide by the rules. 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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