父母同意書 未滿 18 歲的學生 請在瀏覽器中啟用 JavaScript 以填寫此表單。請在瀏覽器中啟用 JavaScript 以填寫此表單。學生姓名 *第一個最後一個ISI的工作人員將會與您聯繫,告知可提供的測試及費用。 Other Consent 父母或監護人的姓名 *第一個最後一個家長的行動電話號碼 *學生的手機 *(請您兒子或女兒在抵達愛爾蘭時使用電話)第二個電話號碼 *家長電子郵件 *電子郵件確認電子郵件同意 *是不ISI 都柏林將僅將上述個人資料用於緊急情況下與您的聯繫。請確認您已同意該項並同意我們其他關於個人資料的政策,詳情請參閱下方「一般資料保護規定」文件,以及我們網站 www.studyinireland.ie/en/site-information/cookie-and-privacy-policy,並點擊「YES」。'抵達日期 *出發日期 *節目 *高中課程 *為團體預訂的一部分個人預訂在愛爾蘭學習的父母或法定監護人的許可與同意有限如果學生年齡未滿 18 歲,則該學生必須由其父母或法定監護人簽署此授權與同意書。直到該文件簽署後,Study in Ireland Limited(以下簡稱 ISI 都柏林或該校或公司)將不會接受該學生參與其所經營的任何課程的安排。. 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 my/our child is required to register their immigration permission, I/we authorise one of the persons listed at 2 above to accompany my/our child to the ISD registration appointment, in accordance with the applicable rules for minors and guardians. I/we understand that ISD may request additional documentation from parents or legal guardians. 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. *無論是ISI都柏林或上述第 2 名人士,都不應被視為在高中課程、夏令營或英語課程中,對任何年齡在 18 歲以下兒童的監護人。使用「監護人」一詞,僅旨在讓ISI都柏林及上述第 2 名人士能夠以「代理親權」的身份行事。. 同意 *是不ISI 紀律與行為協議在整個課程期間,所有學生都受愛爾蘭法律的約束。此外,學生也須遵守其高中課程、夏令營或英語課程的紀律規定及家長所制定的規則。此外,ISI都柏林亦會要求以下事項: 在任何情況下,以下行為都是被禁止的: 1. 飲用任何酒精飲料。2. 使用任何類型的非法藥物或未經處方藥物;與任何參與或與未經處方或非法藥物相關聯的人交往或接觸。 (如果您正在服用處方藥,請告知ISI都柏林)。3. 吸煙。4. 開車或騎摩托車。5. 未經家長許可,在寄宿家庭或寄宿學校過夜。 -ISI 都柏林及- 主人家庭/學校以及-您的父母或監護人(以書面形式) 6. 未經許可而缺席學校。7. 未經許可離開學校範圍或活動場地。8. 在沒有ISI都柏林及您的父母/監護人的許可下,在您居住區以外旅行。9. 向同學借錢或向同學借錢。10. 未經主家及ISI都柏林事先許可,邀請朋友擔任主家或居所住宿的承辦人。11. 在課程中欺凌同校學生或其他學生。12. 在課堂時間使用手機,除非老師指示。13. 工作:學生不得參與任何有薪酬的兼職工作。14. 紋身或身體刺青(除非事先與父母或監護人達成協議)。15. 在沒有許可的情況下在寄宿家庭家中做菜。16. 進行性關係。17. 可能導致他人受傷或損壞其財產的任何行為。18. 超過宵禁時間(詳見下文)。19. 在課堂上表現出令人不安的行為,或在課堂上表現出不當或不可接受的行為。20. 不去上學。所有缺勤都必須有正當理由(例如證實的病假)。此外,高中生們應該注意,如果缺勤超過20天,愛爾蘭教育暨科學部將會進行調查,屆時您不僅會被學校開除,還可能被從高中課程和 HSP 計劃中除名。.同意 *是不其他ISI規則與指南。.1. 你必須在任何時候都尊重你的老師、寄宿家庭、ISI Dublin的所有職員以及其他同學。2. 你必須完成老師分配的所有家庭作業。3. 你必須遵守以下宵禁規定:學生必須遵守這些規定,除非已安排特別活動且獲得事先許可。. 1. 你必須每天晚餐前回家(你可以向你的寄宿家庭確認這個時間),除非學校安排了晚間活動。2. 在週一至週日任何一個晚上,您不得在市中心停留超過晚上 9 點,除非是參加學校舉辦的有組織活動。3. 您從週日到週四的晚上 9點之前,僅可在當地範圍內社交。4. 從週五到週六,您只能在當地範圍內從下午 10 點開始進行社交活動。5. 在所有情況下,寄宿家庭必須知曉以下事項:你將要去的地方在你預計回國的時間誰會和你在一起同意 *是不懲戒處分違反ISI都柏林、寄宿家庭和/或學校的規則與規範,可能會導致以下結果: 第一階段:正式口頭警告(有目擊者)第二階段:首次書面警告(簽署及有證人)第三階段:最後一次書面警告第四階段:驅逐 在嚴重的懲戒案件中,可能會放棄口頭警告或首次或最後一次書面警告。最終情況下,該名學生將被除名,並立即送回家。. 或者,可以對違反紀律的行為施以更嚴厲的懲罰(例如寫道歉信,或提前放假)。. 在愛爾蘭違法(例如從商店偷竊、損壞財產、使用非法藥物)將導致立即被逐出計畫。如果您被逐出計畫,將不予退還費用。. 簽署這份表格,我同意我的孩子將遵守這些規則,並將受制於所列明的所有紀律處分程序。. 賠償形式 愛爾蘭研究有限公司 如果學生年齡未滿18歲,該項保險須由學生與其父母或監護人簽署。在簽署前,該學生不得參與學校安排的任何室外活動。. 考慮到 Study in Ireland Ltd. (以下簡稱 ISI 德布林) 同意為其員工、僱員或代理人安排並授權他們,透過其主要機構直接或間接,帶領我的兒子/女兒/受托人參與活動、旅遊、體育活動以及在ISI德布林辦公場所以外的教育及文化活動,我/我們在此承諾向ISI德布林及其員工、僱員或代理人賠償: (a) 其本人或其任何一人因所述活動/探險/運動及教育與文化旅遊期間或其後所遭受之任何傷害、損害或疾病而可能或已承擔之任何索賠、損害賠償或費用。b) 第三方可能針對他們或其中任何一方提出的任何索賠,其原因為我方所述的兒子/女兒/受托人在上述活動/探險/運動及教育與文化旅遊期間或其後所為之行為或疏忽。. c) 因我/我/我們所述的任何活動/探險/運動及教育與文化旅遊而由他們或其中任何一人為我/我/我們所述的兒子/女兒/受托人而合理地承擔的任何其他費用與開支。. 但以條件為限,本保險條款不適用於因該ISI都柏林及其成員(如有)而應予賠償之索賠、損害賠償、費用或開支,亦不適用於該等索賠、損害賠償或費用之發生或其範圍超出該ISI都柏林及其成員(如有)在任何保險政策下應予賠償之範圍。 我/我們已被告知,在簽署這份文件之前,我/我們應該獲得獨立法律意見。我/我們確認已獲得獨立法律意見,或者我/我們放棄了獲得此類意見的權利。.同意 *是不請在上面列出任何永久性或臨時性醫療或其他狀況(包括特殊飲食和藥物需求),或視障或聽障的需要,這些資訊我該如何告知我的孩子:(如果這不適用於您的孩子,或已透過第三方機構提供過此資訊,請寫「N/A」) 由 1 位父母或法定監護人簽署 * 清晰的簽名 由學生簽署 * 清晰的簽名 日期 *數據處理者的一般資料保護規範• ISI Dublin 是數據處理者,僅會根據客戶的書面指示處理個人資料,而客戶將擔任「數據控制者」,除非法律規定需如此。在這種情況下,ISI Dublin 在處理之前會告知客戶該法律規定,除非該法律因公共利益的重大理由禁止提供該資訊。• ISI Dublin 將採取適當的技術與組織措施,以確保處理符合本條例的規定,並保障資料主體的權利。• ISI Dublin 應制定程序,以確保在與另一供應商合作之前,客戶已獲得通知,該供應商將會處理客戶的個人資料。• 在一般書面授權的情況下,ISI 都柏林將會通知客戶任何有關新增或更換其他處理者的意圖性變更,並讓客戶有機會對這些變更提出異議。• ISI 都柏林承諾保密,或有相關保密義務(保密協議);• ISI 都柏林將: o 採取所有符合處理安全要求之措施。考慮到處理的性質,在可行範圍內,透過適當的技術與組織措施,協助客戶履行其回應資料主體權利要求之義務。o 協助客戶確保遵守個人資料安全相關義務,包括通報個人資料洩漏、資料保護影響評估及事先諮詢,同時亦要考慮處理的性質以及所掌握的信息。o 如客戶選擇,在服務處理結束後,將所有個人資料刪除或退還給客戶;除非法律規定必須保留個人資料,否則將刪除現有的副本。提供客戶所需的所有資訊,以證明其遵守本節規定的義務,並允許及協助客戶或其委任的另一名審計員進行稽核,包括檢查。GDPR協議 *我同意讓這家網站儲存我提交的資訊。.這個表格填寫起來有多容易?1 評分 52 評分 53 評分 54 評分 55 評分 5提交