The Rally Point Registration Form

Registration Form

The Rally Point Shropshire CIC
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Your name

First NameLast Name
Address

Street Address

Street Address Line 2

CityCounty

Postcode
Phone Number
Please enter a valid phone number.Format: 00000 000000.
E-mail address
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Emergency contact (ICE)

First NameLast Name
Emergency contact Phone Number
Please enter a valid phone number.Format: 00000 000000.
Does your Emergency Contact know you visit/intend to visit The Rally Point?
Are you currently serving in the Armed Forces?

Other
Please provide current Regiment/Unit or Regiment/Unit on discharge.
Please provide Unit point of contact, address and phone number/email address.
Are you currently supported by any mental health services? (This question is completely optional but helpful for us to know)

Other
If yes, and you feel comfortable to do so, please provide any relevant information below.
Do you have any physical/emotional/learning difficulties? (This question is completely optional but helpful for us to know)

Other
If yes, and you feel comfortable to do so, please provide any relevant information below.
Do you have any medical conditions that, in the case of an emergency, we should know about?

Other
If yes, please provide relevant information below.
Do you take any medication we may need to be aware of in case of an emergency?

Other
If yes, please provide relevant information below.
Do you have any allergies?

Other
If yes, please provide relevant information below.
Is there anything you would like us to know that may help us better understand any challenges you may be facing?

Other
If yes, please provide relevant information below.
To enable us to ensure fair and proper access to The Rally Point, please provide one each of the following:

Proof of service - Veteran ID. MOD 90. Discharge papers.

Photographic ID - Current UK driving license. Current passport. Veteran ID. MOD 90.

Proof of current address - Utility bill dated within 6 months.

All submissions are encrypted and evidence will be deleted after verification.

Please contact us at info@therallypoint.co.uk with any queries.
Proof of service

Cancelof
Photographic ID

Cancelof
Proof of current address

Cancelof
Consent & Data Protection Statement
By submitting this form, I confirm that the information I have provided is true to the best of my knowledge and that I give explicit consent for The Rally Point @ Cross Bank Farm to collect, store and process my personal data, including any information relating to my health or service history, for the purposes of registration, safety, support and participation in activities.

I understand that:

My data will be processed in accordance with UK GDPR and the Data Protection Act 2018.
My information will be stored securely and encrypted and only accessed by authorised staff members.
My data will not be shared with third parties unless required by law, safeguarding concerns or emergency services for my safety.
I can request access to, correction of or deletion of my data at any time (unless legal obligations require retention).
I may withdraw my consent at any point by contacting The Rally Point.
By signing/submitting, I agree to the processing of my data as described above.
Signature
Should be Empty: