Registration Form

To confirm your place in the youth project, please carefully fill in the entire form below. If you have any questions please contact us via 01707 515513.

* - this field is compulsory

Date of Birth:

Info about different membership types

Please fill in the contact details of the main parent/carer

Please fill in the contact details of a second parent/carer (if applicable)

For your child's safety and protection, we need at least one additional telephone number. This may be the phone number of another relative or a close family friend. It cannot be the same as the primary carer above. Please list the phone number(s) and who they belong to below:


Does the young person have any allergies, dietary requirements, medical condition(s) or other additional needs we should be aware of?


Please tick the boxes below to say you agree with each statement:

By typing my name below, I confirm that I am the parent/carer of the child named in this form. I have read and agree to the statements above, and understand that typing my name will act as my electronic signature.

**Note: There is no legal provision for parents to delegate the right to consent to a child's medical treatment. A child who is able to understand the issues involved in a particular treatment is legally entitled to give their own consent. For most young people this would apply to treatment for minor injuries or ailments. If your child needed more serious medical treatment, the doctor would normally need to get your consent (which could be verbal consent through a phone call) before giving treatment - although urgent life-saving treatment would not be delayed by this requirement. Nonetheless, it can be helpful for medical staff to know that the parent is happy for a youth project leader to discuss decisions relating to the child, and to sign relevant documents relating to treatment.