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Youth and Community North Tyneside

Programme Registration Form

If you are new to attending one of our programmes, or have not registered with us before, please fill in the form below with your child / attendee's information. Thank you.

Area of Work

Identity

Forename

Surname

DateOfBirth

Preferred Pronouns

Telephone

Mobile

Demographic

Gender

Ethnicity

Religion

Programme Information

Health & Support Information

Please select any medical conditions that apply from the list below

Please provide further details of any medical conditions, allergies and dietary requirements, including any medications we need to know about

Please provide details of any learning difficulties or support needs that we should be aware of in the space below

Address

Address1

Address2

Town

County

Post Code

Emergency Contact

Please note that if you are completing this form on behalf of a young person, at least one emergency contact must be a parent / carer.

Emergency Contact 1 Full Name

Mobile Number

Telephone Number

Email Address

Address

Emergency Contact 2 Full Name

Mobile Number

Consent and Data Protection

By signing this form you are consenting for your child / young person to attend and engage in all activities delivered by YMCA. For out of the ordinary activities that are delivered, YMCA will seek permission from carers.

UK General Data Protection Regulations (UKGDPR) / Data Protection Act 2018 (DPA)

Information collected from you will be added to our database. We may use this for administrative purposes in providing our range of services, and for communication with you.

In compliance with the UKGDPR/DPA, all information will be treated confidentially and will not be shared with any other organisation without your explicit and informed consent.

For further information on how we hold and use your personal data, please ask for a copy of our full Privacy Policy

By ticking yes, you are consenting for your child / young person to attend and leave unaccompanied during a weekly session.

By signing this form you are consenting for YMCA to contact you with other marketing information about what else is going on within the organisation. You can opt out of this by contacting the Youth and Community Team at any stage via email to community@ymcanorthtyneside.org

By ticking one more of the boxes below or , you are consenting for photos and videos of your child / young person to be taken and used for marketing and reporting purposes. You can opt out of this by contacting the Youth and Community team at any stage via email to community@ymcanorthtyneside.org