Formulaire de consentement parental

This authorisation and consent form is to be signed by the parents or legal guardian of a student if the student is under 18 years. Until this has been signed Study in Ireland Limited, hereinafter referred to as ISI Dublin or the school or the company will not accept the student for a placement in any course run by it.

1. I/We hereby declare that I/We am/are the parent/legal guardian of the above named student and am/are entitled to full legal custody of him/her.
2. I/We hereby authorise ISI Dublin, its staff, servants or agents to act in loco parentis on my/our behalf and to act as temporary guardians* for my/our child for the duration of his/her stay in Ireland.
3. In particular I/We authorise the persons listed at 2 above to establish a place of residence for my/our child with a host family which has been sourced and inspected by them and conforms to the Irish Department of Education and Science host family standards or in Irish Department of Education and Science approved boarding school accommodation.
4. I/We understand that any damage caused to the property of the ISI Dublin host family by my/our child is our responsibility.
5. I/We hereby authorise ISI Dublin, its staff, servants or agents to provide on my/our behalf, arrival and departure airport transfers for my/our child, including check in service where applicable.
6. Where applicable, I/We further authorise one of the persons listed at 2 above to attend with my/our child at the Garda National Immigration Bureau for the purposes of his/her visa application and to act on behalf of my/our child in relation to the application.
7. I/We hereby confirm that we have answered all questions on the programme application form correctly and honestly and we have informed ISI Dublin of the full details of any medical physical or mental condition my/our child may have, and any medicines which my/our child currently uses.
8. I/We consent that ISI Dublin may pass on relevant medical information to persons that it is of vital interest to, in order to keep them safe.
9. I/We hereby authorise the persons listed at 2 above to administer first aid treatment for any minor injuries or illnesses experienced by my/our child. If my/our child suffers a serious injury or illness I/we authorise the persons listed at 2 above to summon any and all professional emergency personnel to attend, transport and treat my/our child and to issue consent for any x-ray, anaesthetic, blood transfusion, medication or any other treatment or hospital care deemed advisable by and conducted under the supervision of a doctor, surgeon or other medical professional qualified to practise in Ireland. I/We understand that ISI Dublin will only use this authority in an emergency and where attempts to contact me/us have failed or are not possible in the time frame allowed.
10. If my/our child contracts COVID during the stay, I/we confirm that I/we will cover all costs associated with extending our child’s stay in Ireland, where advisable, for the purpose of isolating and/or obtaining a negative PCR test to travel home. These costs include host family fee, transportation fee to test centre, private test costs (if applicable).
11. Where my/our child is required to obtain a negative PCR test to return home, I/we will inform ISI of this, and accept full responsibility for all costs assoicated with the test, including transport to the test centre and the cost of the test.
12. I/We consent to the passing of relevant information to persons that it is of vital interest to in relation to any child protection concerns in adherence with the Children First Act 2015.
13. This authorisation is effective commencing on the date of arrival in Ireland listed above and expiring at the end of the programme
14. I/we agree to pay all of my/our child’s expenses to ISI Dublin for the duration of their stay in Ireland and authorise ISI Dublin to act as financial sponsor for my/our child, where applicable. I/we will supply my/our child with either cash or a credit card for their use during their stay. Note, students are advised not to carry large amounts of cash with them or to leave cash in the host family’s house.
15. In the case of students from outside the EU/EEA, where applicable I/we confirm that my/our child will not seek any financial assistance from the Irish Government or any other Irish body and will not at any stage be a burden on the State.
16. I/we understand that my/our child must abide by the rules of the Summer Camp or English Language Programme or High School programme, as outlined below (Discipline and Behaviour agreement). Should my/our child breach any of the rules as appended hereto I/we understand that they may be expelled from the Summer Camp or English Language Programme or the High School Programme and returned home.
17. I/we understand that if enrolled on an adult programme for students aged 16+, my/our child may be in a class with adult students aged 18+.
18. I/we understand that any personal data that has been shared by us with persons listed at 2 above will be processed in accordance with GDPR regulations which are outlined in the below Contract for Processor.
19. I/we understand that photographs and videos may be taken of my/our child during the programme and that my/our child will be given the choice to be part of them or not. I/we understand and consent that these pictures may be used as part of marketing and/or social media material, but that this consent can be withdrawn at any time.
20. It has been explained to me/us that I/we should obtain independent legal advice before signing this document. I/We confirm having received independent legal advice or alternatively I/We are waiving my/our right to such advices.

*Neither ISI Dublin or the persons listed at 2 above should be construed as legal guardians of any child under the age of 18 on the High School Programme or Summer Camp or English Language Programme. The use of the word “guardian” is solely intended to allow ISI Dublin and the persons listed at 2 above to act “in loco parentis”.

All students are subject to Irish law for the duration of the programme. Students are also subject to the discipline policies and rules of their High School Programme or Summer Camp or English Language Programme and their host family. In addition to this ISI Dublin will insist on the following:

The following actions are in all circumstances prohibited:

1. Consuming any alcoholic beverage.
2. Taking any type of illegal drug or un-prescribed medicine; associating or having contact with any person involved in or associated with un-prescribed or illegal drugs. (You must inform ISI Dublin if you are taking any prescription medication).
3. Smoking.
4. Driving a car or motorbike.
5. Staying away from the host family/residential school overnight without permission from

- ISI Dublin and
- the host family/school and
- your parents/guardian (in writing)

6. Being absent from school without permission.
7. Leaving the school premises or activity without permission.
8. Travelling outside your residential area without the permission of ISI Dublin and your parents/guardian.
9. Borrowing money from classmates or lending money to classmates.
10. Inviting friends to host family/residential accommodation without prior permission from the host family and ISI Dublin.
11. Bullying of fellow school pupils or other students on the programme.
12. Using mobile phones during class time unless instructed by the teacher.
13. Working - students are not permitted to engage in any paid part-time employment.
14. Obtaining tattoos or body-piercing (unless by prior agreement with parents/guardian).
15. Cooking in your host family’s home without permission to do so.
16. Engaging in a sexual relationship.
17. Any acts which might cause injury to someone or damage to someone’s property.
18. Breaking curfew (see below).
19. Disturbing class or behaving inappropriately or unacceptably during class.
20. Being absent from school. All absences must be justified (for example certified sickness). Also High School students should note that if they are absent for 20 days or more the Irish Department of Education and Science will investigate and you could be expelled from both your school and the HSP programme.

1. Respect must be shown at all times to your teachers, your host family, all staff members of ISI Dublin and other students.
2. You are expected to do all homework set by your teachers.
3. You must obey the following curfews:
Students must follow these guidelines except where special events have been organized and prior permission has been granted.

1. You must be home by dinner time each day (you can confirm this time with your host family), except when evening events have been organised by the school.
2. You must not be in the city centre after 9pm on any night from Monday – Sunday, unless as part of an organised school event.
3. You are allowed to socialise in the LOCAL area only until 9pm from Sunday – Thursday.
4. You are allowed to socialise in the LOCAL area only until 10pm from Friday and Saturday.
5. In all cases the host family must be informed of:
o where you are going
o the time you expect to return
o who will be with you

Breaches of the rules and norms of ISI Dublin, the host family, and/or the school, can result in:

Stage 1: Formal Verbal Warning (witnessed)
Stage 2: First Written Warning (signed and witness)
Stage 3: Final Written Warning
Stage 4: Expulsion

In serious cases of disciplinary action, the verbal or first or final written warning may be foregone. In the final case, the student will be expelled from the programme and sent home to immediately.

Alternatively, a punishment more appropriate to the breach of discipline may be imposed (e.g. writing a letter of apology, or an earlier curfew).

Breaking the law in Ireland (such as stealing from shops, damage to property, use of illegal drugs) will result in immediate expulsion from the programme. There will be no refund of fees if you are expelled from the programme.

In signing this form agree that my child will adhere to these rules and that he/she will be subject to all disciplinary procedures as outlined.

Form of indemnity

Study in Ireland Limited

This indemnity is to be signed by the student and the parent or legal guardian if the student is under 18 years. Until this has been signed the student may not take part in any activity arranged by the school off the premises.

In consideration of Study in Ireland Ltd. (hereinafter known as ISI Dublin) agreeing to make arrangements for and to authorise the staff, servants or agents of ISI Dublin, directly or through the principal, to take my/our son/daughter/ward from time to time on activities/excursions/sports and educational and cultural trips outside the premises of ISI Dublin , I/we hereby undertake to indemnify ISI Dublin its staff, servants or agents against:

a) any claims, damages or costs which they or any one of them may be or become liable to pay in consequence of any injury or damage to or illness of me/my/our said son/daughter/ward occurring during or as a result of said activities/excursions/sports and educational and cultural trips.
b) any claims by a third party which may be made against them or any of them in consequence of any act or default of me/my/our said son/daughter/ward during or as a result of said activities/excursions/sports and educational and cultural trips.

c) any other costs and expenses reasonably incurred by them or any of them on behalf of me/my/our said son/daughter/ward during or as a result of any of the said activities/excursions/sports and educational and cultural trips.

Provided that the indemnity herein shall not extend to claims, damages, costs or expenses in respect of and to the extent to which the said ISI Dublin and member(s) of staff or any of them shall be entitled to be indemnified under any policy of insurance

It has been explained to me/us that I/we should obtain independent legal advice before signing this document. I/We confirm having received independent legal advice or alternatively I/We are waiving my/our right to such advices.

• ISI Dublin is a Data Processor and shall process personal data only on the written instructions of the Client who shall be the ‘Data Controller’ unless required to do so by law. In such cases ISI Dublin shall inform client, of that legal requirement before processing, unless that law prohibits such information on important grounds of public interest.
• ISI Dublin shall implement appropriate technical and organisational measures in such a manner that processing will meet the requirements of this Regulation and ensure the protection of the rights of the data subject
• ISI Dublin shall have a procedure in place to ensure that client is notified prior to ISI Dublin’s engagement with another supplier which is acting as a sub processing of client’s personal data.
• In the case of general written authorisation, ISI Dublin shall inform client of any intended changes concerning the addition or replacement of other processors, thereby giving client the opportunity to object to such changes.
• ISI Dublin commits to confidentiality or are under an appropriate obligation of confidentiality (Non-Disclosure / Confidentiality Agreement)
• ISI Dublin shall:

o take all measures required pursuant security of processing.
o taking into account the nature of the processing, assist client by appropriate technical and organisational measures, insofar as this is possible, for the fulfilment of client’s obligation to respond to requests for exercising the data subject’s rights
o Assist client in ensuring compliance with the obligations pursuant to security of Personal Data, notification of Personal Data breaches, Data Protection Impact Assessment and prior consultation, taking into account the nature of processing and the information available to it
o at the choice of client, delete or return all Personal Data to client after the end of the provision of services relating to processing, and delete existing copies unless the law requires storage of the Personal Data.
o make available to client all information necessary to demonstrate compliance with the obligations laid down in this section and allow for and contribute to audits, including inspections, conducted by client or another auditor mandated by client