Family Debriefing Retreat

Child Application Form

NOTICE: Before you fill out the application form below on behalf of your child, we want to assure you that we fully respect your privacy and will always keep your details confidential. They are never shared with a 3rd party. We use this information only to determine our ability to serve you. We will email you at the address you provide to notify you whether your application is accepted and/or to clarify any further information.

We do not use this information to make any automated decisions that might affect you or your child. If your family is accepted for debriefing, your information is securely archived. Only the information you voluntarily share with us in the form below is collected.

If we are unable to accommodate your request (due to dates, etc.), your information is automatically deleted after 30 days unless you request to be waitlisted. You have the right under EU law to request that your data be erased so feel free to contact us after your debriefing if you would like us to delete your identifying information from our records.

22 – 27 June 2025

or

13 – 18 July 2025

Child Family Debriefing Application Form

Please acknowledge you have read the above notice and agree with it before filling in this form on behalf of your child: Please acknowledge you have read the above notice and agree with it before filling in this form on behalf of your child: I Agree

Please select one: Please select one: 22 - 27 June 2025 13 - 18 July 2025

First Name

Family Name

First Name for Name Tag

Age at time of debriefing

Sex

Place of birth

Nationality

Does your child need a visa for France? Does your child need a visa for France? Yes No

Country you have been living in

Country where your child has been attending school (if different)

Total years/months on the field

Length of stay on field this term

Reasons for coming home this time (if different from parents)

Special concerns connected with changing locations at this time or anything different we should understand concerning a crisis this child has been through

Preferred language for debriefing - 1st choice

Preferred language for debriefing - 2nd choice

Is your child taken any prescribed medications? Is your child taken any prescribed medications? yes no

Please explain

Is your child under the care of a professional psychologist or psychiatrist? Is your child under the care of a professional psychologist or psychiatrist? yes no

Please explain

If your child is on a special diet or has any special food requirements, please explain

10 + 8 =

Find us:

We are physically located in France, only 15 minutes from the Geneva, Switzerland airport:

2067 Route de Tutegny

01170 Cessy, France

Tel: +33(0)450.28.03.81