JUT Young Connect Registration Form

MOVE, CONNECT, THRIVE!

We're running a monthly program for young people aged 11- 18 from the Global community focusing on social action, media, dance,mental, academic and financial well-being.

Our goal is to equip young people with tools, knowledge and experiences to navigate academic pressures, social media, mental health, finances and identity pressurees while building confidence, community impact and leadership skills.

Sessions are free and will be held forthnightly, In-person.

Sessions starts- Saturday 25th April 2026. 12- 2 PM.

@ New Covenant Church, Charlton

61, Rathmore RD

SE7 7QE

This form must be completed by parents or carers.

Young Person's Information

Name

First NameLast Name

Age

Email

example@example.com

Phone Number

Area CodePhone Number

Gender

Other

Address

Street Address

Street Address Line 2

CityCounty

PostcodeCountry

Please choose an option that best describes your child's ethnicity.

This data is collected for monitoring purposes only.

Please state below if your child has any learning difficulties or special needs.

Signature

Parent/Carer Information

Name

First NameLast Name

Phone Number

+44Phone Number

E-mail

Relationship to child

Informed Consent and Acknowledgement

I hereby give my consent for my child’s participation in the Young Connect program with Joined Up Thinking JUT CIC.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE.

ON RECEIPT OF THIS APPLICATION, A CONFIRMATION EMAIL WILL BE SENT TO YOU.

Privacy

All personal information collected by Joined Up Thinking JUT CIC is strictly private and confidential. We will not share your information with any third parties, unless required by law to do so.

Please verify that you are human