All About Us and Cumnock registration forms April 2023

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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
Cumnock on a Wednesday night starting on the 26th of April 6-8pm

Please use this survey to register for your youth group

Personal Information:

This question requires an answer

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

This is required

Kilmarnock Youth Group

Cumnock Youth Group

Would you like one of our youth workers to contact you?

Yes

If yes, what is the best way to contact you eg email, text, phone call?

This is required

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

yes

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..

YES

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.

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Personal Information:

Kilmarnock Youth Group

Cumnock Youth Group

Would you like one of our youth workers to contact you?

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