REGISTRATION

FORM

In order to operate POINT (Fishguard and Goodwick Young Persons’ Trust) we need to store information about your child such as their name, age, gender and telephone number, emergency contact details, medication etc. Please note that these details are kept strictly private and stored securely in accordance with Data Protection. We only use your child’s personal information when we need to, such as making contact in an emergency or recording their attendance at the centre. By completing and signing this form you are providing consent for us to hold this information. We will store it securely and it will be kept for a period of up to 10 years after your child has stopped engaging with our services depending on the requirements of our funders. If your child stops engaging with our service, we will keep your child’s personal information until they are 26 years old, in case they would like to reengage with our services at any time. Please update us if your child’s details change. Please refer to our Privacy Notice if you would like to find out more about how we store, process and delete your information. The Privacy Notice can be obtained by getting in touch via our Facebook page Point Youth Centre or by emailing zoedavies@pointypt.org.uk

Personal Information

Full Name *

Date of Birth *

Gender *

Preferred Pronouns *

Ethnicity * Present Address * Postcode * Young Person Mobile Number * Child’s Doctor Surgery *

Emergency Contact 1

Full Name *

Telephone Number *

Relationship to Young Person *

Emergency Contact 2

Full Name *

Telephone Number *

Relationship to Young Person *

Health Information Medical Conditions / Allergies Physical Disabilities or Additional Learning Needs

Photography Consent *

I give you permission to take photographs or film of your child taking part in activities. These may be used in the local press, website, tv and publication materials, locally and nationally. By ticking yes you are providing your consent for us to process and share photographs or film of your child’s activities. If you change your mind, please let us know by phoning 01348 875467.

Yes No

First Aid Consent *

Do you give consent to staff administering your child with basic first aid, should they need it?

Yes No

Behaviour Expectations

Please ask your child to read the below behaviour expectations and sign after they have read and understood

I will be respectful towards the POINT staff, volunteers and other members
I take responsibility for looking after any of POINTS equipment that I use
Bullying or discrimination of any form is not acceptable
I understand POINTS fire evacuation procedure
I understand that POINT does not allow drugs, alcohol or energy drinks
I will accept staff decisions without argument
If I disagree, I will make an appointment to discuss this with the Drop in Manager / Project Manager
I take full responsibility for my belongings
POINT is not responsible for the loss or damage of my personal items
I understand that I must meet the above behavior expectations. If I do not, I may be asked to leave for an extended period

Signatures Signed (Young Person) * Signed (Parent / Guardian) * Date *