Registration Form – Adult Achievement Awards & KO-NEKT Krew (Ages 16–25)
The KO-NEKT Krew group is a supportive space for young people aged 16–25 to build skills, confidence, and gain an Adult Achievement Award – an accredited qualification awarded by Newbattle Abbey College. Please read the information below carefully and tick the relevant boxes to provide your consent.
Participant Name
*
First Name
Last Name
Parent Name
*
First Name
Last Name
Participant or Parent Email
*
example@example.com
Participant or Parent Phone Number
*
-
Area Code
Phone Number
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Diagnosis or Level of Need (if applicable):
Health Conditions, e.g. Allergies, epilepsy, medication administration. (Please provide as much detail as possible if applicable)
Participation Consent
*
I consent to take part in the KO-NEKT Krew group.
I consent to be registered for and work towards the Adult Achievement Award qualification with KO-NEKT and Newbattle Abbey College.
Parental Consent
*
I consent to my child to take part in the KO-NEKT Krew group.
I consent to for my child to be registered for and work towards the Adult Achievement Award qualification through Newbattle Abbey College.
Information Sharing
To award the qualification, KO-NEKT CIC must share certain information (such as name, date of birth, progress, and portfolio work) with Newbattle Abbey College. This will only be used for qualification and certification purposes only.
Information Sharing with Newbattle Abbey College
*
I consent to my information being shared with Newbattle Abbey College for the purposes of gaining my Adult Achievement Award.
Photographic and Video Consent
*
I consent to photographs/videos being taken of me/my child during activities.
I consent to my/my child's photographs/videos being shared with Newbattle Abbey College.
Social Media Consent
*
I consent to my/my child's photographs/videos being shared on KO-NEKT CIC’s social media platforms.
I consent to my/my child's photographs/videos being shared on Newbattle Abbey College social media platforms.
Travel Arrangements: Please indicate how you will travel to/from the KO-NEKT Centre for group sessions:
*
I/My child will travel independently to and from the KO-NEKT Centre.
I/My child will be dropped off and collected from the KO-NEKT Centre.
I/My child will be dropped off and travel home independently from the KO-NEKT Centre.
I/My child will travel independently to the KO-NEKT Centre and will be collected from the KO-NEKT Centre.
Emergency Contact Details
Name of Emergency Contact:
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Consent Declaration
I have read and understood the information above. I understand that I can withdraw my consent for any part of this form at any time by contacting KO-NEKT CIC.
Name of Participant:
*
First Name
Last Name
Date:
*
-
Month
-
Day
Year
Date
If the participant is
under 18
, a parent/guardian must also sign:
Name of Parent/Guardian:
First Name
Last Name
Signature of Parent/Guardian:
Date:
-
Month
-
Day
Year
Date
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Should be Empty: