RYC Registration Form
Please complete one form per participant to register for RYC. If you wish to apply for a bursary, please also complete our bursary application form. This form must be completed by a person over the age of 18.
Participant Information
Name
*
First Name
Last Name
Preferred or other name
Pronouns
*
she/her
he/him
they/them
Other
Name of School or Education Setting
*
Date of Birth
*
-
Day
-
Month
Year
Date
School Year (2024/25)
*
Please Select
Year 1
Year 2
Year 10
Year 11
Year 12
Year 13
Address
*
Street Address
Street Address Line 2
Town/City
County
Postcode
Does the participant have any allergies, medical conditions or neurodiversity?
*
Yes
No
If yes, please tell us more
Is there anything else we should be made aware of?
Emergency Contact Information
Emergency Contact 1
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
Town/City
County
Postcode
Are you the fee payer?
*
Yes
No
Emergency Contact 2 (optional)
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
Town/City
Country
Postcode
Terms and Conditions
I consent to:
*
The participant taking part in this programme
The Roses keeping record of this form for health and safety, and safeguarding purposes
Any medical treatment that the participant may need to be given in an emergency
The participant being filmed or photographed during the programme, with such photographs or recordings being used for marketing and publicity with third party organisations
Signature
*
Submit
Should be Empty: