YOUTH TRANSFORMED

Registration

This form is to be completed by a Parent or Guardian ONLY please.
A separate form needs to be completed for each participant.

PLEASE FILL IN ALL FIELDS then press SEND FORM at bottom

Once completed, we will put your name on file. NOTE HOWEVER your place is NOT guaranteed until you pay a £20 deposit to your youth leader or direct to Transform by the end of May.

If paying electronically remember to name the participant(s) in the reference field.

Please email mike for Transform bank details.

First Name:      Surname:

Age:       Date of Birth:   

Sex

Address:

 

 Postcode:

Church            How long have you been there?

Participants Email:           Participants Mobile: 

 Parents First Name:           Parents Surname:

Parents Mobile:            Parents Landline: 

Parents Email 

Do you have any Medical Conditons or Allergies?

 

 Any special dietary needs?  (E.g. Vegetarian) 

 

Name of person to be contacted in an emergency:

Emergency contact number: 

Relationship of emergency contact to participant: 

 
Please read the following information carefully and tick the box as appropriate.

We require your consent for number 1 and 2 in order for us to take this registration forward.  Number 3 is optional, but we would hope that you would grant your consent based on the use of the pictures and videos you have seen throughout this website.  However, your child is still very welcome to attend whether or not consent is given.

1.  MEDICAL MATTERS

I hereby authorise the Youth Leaders/Management Committee to retain such medical care and treatment as they deem necessary at their sole discretion for my child. I understand that this could include giving paracetemol under supervision if required.  I agree to the performance of such treatment, anaesthesia and operation as deemed necessary in the opinion of the attending physicians.

I agree   

 

2.  MEDICAL INSURANCE

I acknowledge that the YouthTransformed Team have not taken out medical insurance for my child, and that they will not be liable for any accident, sickness, loss or damage should this occur during the mission.

I agree 

 

3.  CONSENT TO USE IMAGES

I agree that my child may be filmed as part of the mission and I agree that these images may be used for the promotion of YouthTransformed activities.

I agree