Joining Form
Complete all the required questions, book your onboarding call then hit submit. After approval you can start booking activities straight away via “Acuity” our booking system, Join the WhatsApp group and start connecting with like-minded people. Tegcic.org.uk - we're not just a group — we're a growing community built on trust, courage, and connection
Date
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Email
*
example@example.com
Preferred Name
Date of birth
*
-
Day
-
Month
Year
Date
Phone Number
Address
*
Street Address
Street Address Line 2
City
Country
Postcode
Address
*
Location (City/County)
*
Middlesbrough
Redcar
Stockton-On-Tees
Thornaby-On-Tees
Darlington
Durham
Yarm
Other
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Emergency Contact
Emergency contact name
Emergency contact phone number
Current Wellbeing / Support Needs
Current State / General Well-being (Simple Mood Check)
Low Mood
1
2
3
4
Good Mood
5
1 is Low Mood, 5 is Good Mood
Are there any particular challenges you're currently facing? (We have trained professionals with access to external tools and resources to support your needs)
*
Mental health
Social isolation
Unemployment
Grief
None
Other
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Expectations and Commitments
What activities interest you most?
*
Please Select
Football
Bowling
Chess/Checkers
Table Tennis
Go-Karting
What is your skill level of it?
*
Beginner
Intermediate
Advanced
Expert
Would you be able to travel for group events?
*
Yes
No
What kind of group events/projects would you be interested in?
*
Move: Physical Wellbeing
Connect: Mental Stimulation
Escape: Social Activities
Safe Space Teesside
Teesside Active Men's Club
Group Fitness
Group Park Walks
When would you prefer to join our group events?
*
Rows
Thurs
Fri
Sat
Sun
Mon
Tues
Wed
Afternoon
Evening
Equality & Diversity Monitoring
At Teesside Empowerment Group CIC, we’re committed to making our programmes inclusive, welcoming, and representative of the communities we serve. The following questions are designed to help us understand who is accessing our services and ensure we’re reaching people from all backgrounds fairly and respectfully.
Age Group
*
18-24
25-34
35-44
45-54
55-64
65+
What gender do you identify as?
*
Female
Male
Non-binary
Prefer not to say
Disability / Long-Term Health Condition: Do you consider yourself to have a disability or long-term health condition that affects your day-to-day life?
*
Yes
No
Prefer not to say
Employment Status:
*
Employed
Self-emplyed
Unemployed
Retired
Student
Other
Prefer not to say
Ethnic Background
*
White (British, Irish, Other)
Black / African / Caribbean / Black British
Asian / Asian British
Mixed / Multiple ethnic groups
Prefer not to say
Other
How did you hear about us?
*
Instagram Ad
Facebook Ad
Friend/Family
Event
Social Post
Flyer/Poster
Other
Declaration Section
Please read and confirm the following statements by selecting Yes or No
I understand and agree to abide by the groups values, code of conduct, and confidentiality guidelines. Review values: https://tegcic.org.uk/values
*
Yes
No
I consent to being contacted about group activities, updates, and opportunities.
*
Yes
No
I acknowledge that participation is voluntary and that I can withdraw at any time.
*
Yes
No
By checking the box below I confirm that I am physically and medically fit for recreational activities such as football, badminton, table tennis, and group walks. I understand that I have no known medical issues or physical conditions that would prevent me from safely participating with you. I also understand that I am responsible for my own safety and should not take part if a medical professional has advised me to avoid such activities.
*
Confirm
Keeping a Safe Space
As part of our verification process, we ask all new members to join a short call. This helps ensure a genuine and secure space for everyone.
IMPORTANT: Scroll down and click Submit after booking your onboarding call
*
IMPORTANT: Scroll down and click Submit after booking your onboarding call
*
Submit
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