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INTERNATIONAL POLICE ASSOCIATION - DOC

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									                              INTERNATIONAL POLICE ASSOCIATION
                                      UKRAINE SECTION

                           INTERNATIONAL YOUTH GATHERING (IYG)
                                 JULY 11 – 25, 2004, UKRAINE

                                           REGISTRATION FORM


1.   APPLICANT:
Surname…………………………………………………... First Name………………………………………………..
Date of Birth…………………………………….. Blood Group……………………………………………………….
Allergies/Diets/Diseases………………………………………………………………………………………………...
Nationality…………………………………….. Religion…………………………..…………. Sex: M / F
Address………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………..
Tel: ……………………………………………..… E-mail ……………………………………………………………
Studies/Occupation……………………………………………..………………………..……………………………...
Languages spoken…………………………………………..Sport/Hobbies…………………………………………...

2.   APPLICANT’S FAMILY:
Full Names of Parents:     1. Mother…………………………………...Occupation……….…………………………...
                           2. Father………………………………….…Occupation……………………………….…...
Name of IPA Member (parent/grandparent)……………………………………………………………………………
IPA Membership No……………...
Person to be contacted in case of emergency…………………………………………………………………………...
Full address……………………………………………………………………………………………………………...
Phone/Fax No……………………………………………………….. E-mail…..……………………………………...

3.   PROCEDURES:
You are required to sign the Terms and Conditions Agreement overleaf. The form, having been completed, is to be
submitted through the Secretary of your local IPA to the Executive Committee of your National Section, who will
forward the document to the Organisational Committee of IYG2004. If Registration is accepted, you will be required to
provide particulars of Travel (Medical) Insurance and method of travel to the Gathering.
Closing date for registration: 31st May 2004

4.   VERIFICATION BY SECTION
The parent/grandparent is a current member of IPA (print name)……………………………………………………...
Signed……………………………………………..Official Status…………………………………………………..

5.   ADDRESS OF THE ORGANISING SECTION OF THE IYG 2004
IPA Section Ukraine / IYG 2004
1 Solomianska square, Kyiv – 03035, Ukraine
E-mail: icd@naiau.kiev.ua Phone + 38044 248-89-58             Fax + 38044 248-89-58

6.   PAYMENT INFORMATION
The fee for participation is 450 euros. The deposit of 200 euros must be sent with the registration form. The balance of
250 euros must be paid no later than 31st May 2004. The applicant must pay the cost of transferring money.
IPA Section Ukraine,
Account No 2600600001050 “Pravex-Bank” GSC
SWIFT CODE: PRAVUAUK
Commerzbank AG Frankfurt/Main Germany
SWIFT CODE: COBADEFF
                               INTERNATIONAL POLICE ASSOCIATION

                                INTERNATIONAL YOUTH GATHERING
                                    JULY 11 – 25, 2004, UKRAINE




1.   OBLIGATION OF THE APPLICANT – TERMS AND CONDITIONS

     You are going abroad as a representative for your country and your IPA National Section will be judged according
     to the way you conduct yourself. You should therefore remember that you are an ambassador and as such, you are
     responsible for your conduct and general behaviour.

     The object of the trip is to bring you into contact with persons from other countries so that you will get to know
     their way of life, their thinking and their culture. Thus, helping to promote better understanding between peoples in
     the best traditions of the International Police Association. You should therefore try to establish and afterwards
     maintain contact with your new friends – in other words “be a mixer and become involved”.

     Every participant will be required to produce a written account of their experience during the Gathering.

     Participants are prohibited from consuming alcohol and other drugs. You will not be permitted to drive a motor
     vehicle while under the control of the International Youth Gathering. You will immediately be sent home should
     the Organisers decide that your actions and conduct are not in the spirit of the International Police Association.

    Those who do not agree with these guidelines and are not prepared to conform, should not apply for the
    International Youth Gathering.
_____________________________________________________________________________________________

2. APPLICANT’S AGREEMENT:

     I, the undersigned applicant, hereby acknowledge that I have read the above Terms and Conditions of the
     International Youth Gathering and agree to honour them without exception. I further understand that during my
     period of residence with the International Youth Gathering, I will be under the full control of and responsible to,
     the Organising Committee and to the adult members of any host families.

    Signature of Applicant………………………………… Date…………………………………………………...
_____________________________________________________________________________________________

3. PARENTAL CONSENT:

     Our son/daughter has discussed the matter of the International Youth Gathering with us, we have read the
     “Obligations of the Applicant” and we agree that he/she has our permission to apply for participation in the
     International Youth Gathering. We, the parents of the applicant shown overleaf, hereby grant permission for our
     son/daughter to travel abroad under the Terms and Conditions of the IPA International Youth Gathering, which we
     have read and agree to abide by. We further certify that our son/daughter will be insured against illness, accidents
     and third party risks during his/her stay abroad. We hereby declare that he/she is in good health and has, as far as
     we know, no contagious disease. Should serious illness occur during his/her stay abroad, his/her hosts are
     authorised to ask for medical advice, the cost of which shall be our responsibility. We also agree to pay the cost of
     transportation to and from the host country and we will provide our son/daughter with adequate spending money
     to cover the duration of his/her stay.

     Signature of Parents …………………………………………………………... Date……………………

_____________________________________________________________________________________________

								
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