YMCA Youth Cresset Sign-Up

YMCA Youth Cresset Sign-Up
** When inputting phone numbers, please do not include the first 0

(e.g 07902, please write as 7902) **
Date*

MonthDayYear
Date
Please list 3 goals that you/your child want to achieve with the help of YMCA Youth Cresset.
Are you a parent/guardian filling this out on behalf of a young person?*

YesNo
If you responded 'Yes' to the above, please answer this section.

If you answered 'No' you can skip to the next section
What is your relationship to the young person?
Your full name

First NameLast Name
Your Phone Number
Please enter a valid phone number.
Your Email Address
example@example.com
Please select a box to indicate that your young person is NOT to partake in that activity

Photographs/videos taken for publicityAge appropriate workshops on sexual health, drugs and alcohol, etcUse of sun cream when neededHaving face paint appliedBe allowed to leave during sessions with staff to go to the beach, park, etcFor trained staff and volunteers to administer first aidYoung person to come and go from drop in sessions
Please read the below agreement and sign below once you have completed the form.
YMCA Youth Privacy Agreement

YMCA Youth takes your privacy seriously and we do all we reasonably can to protect that privacy and are committed to the security of your data.

To ensure you receive all opportunities available to you, we will need to contact you via phone, email, post and Facebook to give you youth updates, share youth news and send you activity packs.

Personal information at times will need to be shared with third parties (a person not YMCA Trinity) such as Peterborough County Council and other agencies working directly with you.
Parent/Guardian Signature

Clear
End of section.
Name of young person*

First NameLast Name
Young person's date of birth*

MonthDayYear
Date
Young person's country of birth*
Name of school/college young person attends *
Address of young person*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please let us know of any disabilities/illnesses the young person has that may be an issue when taking part in physical activities such as sports, dancing, martial arts, etc*
Please tell us any known allergies/dietary requirements for the young person*
If you are a young person filling this out on their own behalf, please make sure your First Emergency Contact is a parent/guardian we can contact for permission for you to attend our sessions.

We will be contacting both Emergency Contacts for permission to store their information in case of emergency.
First emergency contact*
Please enter a valid phone number.
First emergency contact full name*

First NameLast Name
First emergency contact relationship to young person*
First emergency contact address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Second emergency contact*
Please enter a valid phone number.
Second emergency contact full name*

First NameLast Name
Second emergency contact relationship to young person*
Second emergency contact address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Thank you for signing up to the YMCA Youth Cresset!

We'll be sure to get in touch soon to complete the sign up process.

In the meantime, you can keep up to date with what we're doing on both Instagram and Facebook at @YMCAYouthCresset.
Before signing up please ensure that you/your child has read our code of conduct, created by our youth club members.

By signing up, you/your child agrees to follow the below code of conduct:

1. Respect everyone

2. Respect our space and equipment

3. Tell staff if you feel unsafe

4. Get involved and have fun

5. Be a good role model
Should be Empty:

YMCA Youth Cresset Sign-Up

If you responded 'Yes' to the above, please answer this section.

Please read the below agreement and sign below once you have completed the form.

End of section.