REGISTRATION FORM

REGISTRATION FORM
Young person's full name
Gender
Date of Birth

Month Day Year
Date
Home Address
Is an Interpreter required?
Parent/Guardian's Name
At school

Are you ? On a Training Scheme At college Employed Voluntary work At university Unemployed Other Carer
Does they have a disability (diagnosis if known) and/or support needs?
Do they have any medical conditions?
Does they have any allergies?
Name of School/College (including postcode)
Activities your child likes/dislikes
Sports activities
Are there any other activities
Are there any other activities that your child particularly
activities that your child does
Are there any particular activities that your child does
that you feel it would be helpful

Equality Monitoring Information

Which ethnic group do you identify with?
Caribbean

Asian Bangladeshi Black African Mixed White & Asian White British Asian Indian Black Mixed White & Black White Irish Asian Pakistani White Other Asian Other Black Other Mixed White & Black Other Chinese Mixed Other
for my child's name and personal data to be processed by the Caxton Youth

Your signature, or parent/guardian (if under 16)

When this form is complete please send it back to-

Caxton Youth Organisation Basement Clubrooms, Tintern House, Abbots Manor Estate, Alderney Street,

or e-mail to Rosemary Swainston, rose@caxtonyouth.org
PHOTO CONSENT FORM
At Caxton Youth Organisation, we also use photos and videos for publicity and marketing, such as on the Caxton website, in newspapers, posters, and on other websites such as Facebook or Twitter. We would like your permission to do this.

(name) do/do not give my permission for Caxton Youth Organisation to use photographs and videos of my child for the following purposes:

Please tick the box to say if you are happy for us to use a photograph or video of you:
On the Caxton's website

On the Caxton's Facebook page
On the Caxton's Facebook page

On the Caxton's website
On the Caxton's Facebook page

On the Caxton Instagram account
On the Caxton YouTube Channel

In our literature
In articles (in print or online)
twitter
Caxton member
Parent/Carer (if applicable)
Should be Empty:

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REGISTRATION FORM

PHOTO CONSENT FORM

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