Tinneys Youth Club - Registration

Child / Young Person

First name *

Surname *

Date of birth *

School *

Parent / Carer

First name *

Surname *

Telephone number *

Alternative telephone number *

Email address *

Alternative email address *

Allergies

Does the young person have any allergies that Tinneys Youth Club staff need to be aware of? *

No Yes

Medical Conditions / Medication

Does the young person have any medical conditions, medication or other health information that Tinneys Youth Club staff need to be aware of? *

No Yes

Email Communications

We may occasionally email parents/carers with information about Tinneys Youth Club activities, events and related information.

Would you like to receive these emails? *

Yes, I agree No, I do not agree

Photography & Video

From time to time, photographs or videos may be taken during Tinneys Youth Club activities. The choices below are separate, so you can decide how images may be used. Giving consent is optional and will not affect participation in Tinneys Youth Club.

Printed materials *

May photographs or videos of the young person be used in printed publicity materials such as leaflets, posters, newsletters or annual reports?

Yes, I agree No, I do not agree

Website & social media *

May photographs or videos of the young person be used on the Tinneys Youth Club website and official social media accounts, such as Facebook and Instagram?

Yes, I agree No, I do not agree

First name alongside image *

May the young person's first name be used alongside a photograph or video? We will not publish the young person's full name, address, telephone number, email address or other contact details alongside an image.

Yes, I agree No, I do not agree

Declaration

I confirm that I am the parent/carer or have responsibility for the young person named on this form and that the information I have provided is accurate and complete.

I confirm the above declaration. *

Parent / carer signature *

Please sign in the box below using your finger, mouse or stylus.

Your Information

The information provided on this form will be used to administer Tinneys Youth Club, manage attendance and help ensure the safety and wellbeing of participants. Information will be stored securely and accessed only by authorised people who need it for these purposes.

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