Blackwater Valley Young Leader Registration

Blackwater Valley Young Leader Registration

To be completed by the young person’s parent/care giver/responsible adult.
DATA PROTECTION
Personal data regarding you and your child, whilst they are in Scouting, will be held and used in accordance with applicable Data Protection legislation.
Name of Young Person*

First NameLast Name
Young Person email address*
example@example.com
Young Person Mobile Phone Number*
Please enter a valid phone number.
Date of birth for Young Person *

DayMonthYear
Date
Name of responsible adult completing this registration *

First NameLast Name
Email for responsible adult *
example@example.com
YesNo - please help me find one
Which section interestes you?
Which scout group do they wish to volunteer with?*
And which section?
YesNo
Please ask your scout troop/explorer unit to share their Online Scout Manager (OSM) record with Blackwater Valley Young Leader Unit. Instructions are here
No - direct from scoutingYes - DofEYes - Girl GuidingYes - other organisation
What other organisation are you volunteering through?
About the Young Person
Which scout troop are they coming from?*
Home Phone Number*
Please enter a valid phone number.
Home address *
Doctor’s name and surgery address*
Do they have any medical conditions or allergies, take any medication, have any dietary requirements or additional needs?*
Ethnicity
Religion
First Emergency Contact
Name*

First NameLast Name
Emergency contact number*
Please enter a valid phone number.
Second Emergency Contact
Name*

First NameLast Name
Emergency Contact Number *
Please enter a valid phone number.
By signing this form, I confirm that I have parental responsibility for the participant. She/he is in good health and I agree to him/her being a Young Leader. I acknowledge the need for appropriate and responsible behaviour on his/her part and that the Leaders reserve the right to send any Young Leader home.

I give permission for the leaders to seek medical help in the event of any emergency. In the event I cannot be contacted, I give general consent to the treatment (including the use of anaesthetics) advised by the medical authorities and give my permission for a leader to sign any forms required.

I accept that the Medical Authorities can insist on parental authority before treatment commences.

I agree to the data protection statement above.
Signature*

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Blackwater Valley Young Leader Registration

About the Young Person

First Emergency Contact

Second Emergency Contact