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Young Persons Development Group

Network Ambassador/Young People’s Development Group Application

Which group(s) are you part of?



 

Youth Zone

Young Person Details

First Name

Last Name

Street

City

Postcode

Date of Birth (DD/MM/YYYY)

Gender

Home Phone

Mobile

Email

School/College/Employer

Ethnicity

Disability

Additional Needs

Medical Conditions

Any other information you would like us to know?

Emergency Contact Details

Please provide details for two emergency contacts.

Emergency Contact 1

The first emergency contact must be a parent/guardian. If you are under 16, this must be the same person who completes the Parent/Guardian Agreement below.

Emergency Contact 1 Name

Relationship to Young Person

Emergency Contact 1 Phone

Emergency Contact 1 Email

Emergency Contact 1 Address (if different from above)

Emergency Contact 2

The second emergency contact should be another person who can be contacted if the parent/guardian is not available. By providing their information you confirm you have their consent to use their information for this purpose only.

Emergency Contact 2 Name

Relationship to Young Person

Emergency Contact 2 Phone

Emergency Contact 2 Address (if different from above)

Consent

By signing up as a Group member, you (and your parent/guardian for under 16s) give consent for all meetings, trips and activities taking place as part of the Group. Events and meetings may take place at short notice, however whenever possible notice will be given.

Your personal data

By signing up as a Group member, you agree to provide OnSide with certain personal information, which we will process in accordance with all applicable data protection laws to: