All About Us and Cumnock registration forms Feb 2024

Youth Group Registration Form

This survey will allow you to register to attend our Community Youth Groups
This programme targets p7+.

Looking for something to do?

Come along and try out the activities and have some fun. and most importantly get support in a safe environment.
Only 20 places so be sure to sign up quick to ensure that you have a place.
There will be various activities planned for each session.
So if you are part of the LGBT+ Community questioning or a friend or Ally please come along.

We run 2 groups

Kilmarnock on a Monday night 6-8pm starting 5th February 2024 Bonnyton Community Centre

Cumnock on a Wednesday night starting on the 7th of February 2024 Yipworld Cumnock

Please use this survey to register for your youth group

1. Personal Information:
*

Participants Name	*
Date of Birth	*
School	*
Year Group (p7, S3 etc)	*
Young Person Mobile Number	*
Young Person Email Address	*
Does the participants have an Additional support needs	*
Medical Conditions	*
Any Allergies if so we will contact you for further information	*
Dietary Requirements	*
Parent/Guardian Name	*
Contact Number	*
Email Address (important for further consent forms eg trips )	*
Emergency Contact Name	*
Emergency Contact Number	*
Address	*
Postcode	*

Please provide any additional information, if the participant has an Additional support need please outline this in detail and the support they receive within their School

2. Kilmarnock Youth Group

3. Cumnock Youth Group

4. Would you like one of our youth workers to contact you? *

Yes
No
If yes, what is the best way to contact you eg email, text, phone call?

5. 5. Publicity photographs and video/film footage may be taken at our sessions and used by East Ayrshire Council for a period of 1 year in printed materials and on social media (including East Ayrshire and Vibrant Communities Twitter). I agree to photographs and/or film being taken of my child

6. On occasions we would like to walk the young people to the local parks to use the Multi Use Games Area (MUGA) or play sports.
Or to go a walk around the local area for activities like litter picking etc
We require your consent to take the young people out of the club to participate. Please let us know if you consent to your child participating..

Participants must be registered prior to attending.

You will NOT be emailed with confirmation of registration so please take a note of all activities you have signed up for.

The personal information we have requested from you is required to make contact with you in the event of an of emergency. Your information will be used for this purpose only and processed and held securely in terms of Data Protection Legislation.
For further information on our legal basis for processing your information and your rights in terms of Data Protection Legislation, please visit our privacy statement.

You can see all the guidelines here: http://eacwamp02/cms/guidelines/consultations/

Thank you for registering for our youth groups we look forward to seeing you all.