Creative Course Sign up form

Which session/s would you like to sign up to:
Personal Details
Do you have any previous criminal convictions or have a criminal record? If ’yes’ please provide details
Medical Details
Parent/Guardian Emergency Contact Details:


I agree that any information provided on this form, during the project/course can be used by Creative Youth Network (CYN) and shared with other organisations working with them to help deliver, fund and evaluate our programmes, and for the benefit of my welfare, safeguarding or future journey. I understand I have the right to ask to see information held about me by CYN. For further information about how CYN uses your information please ask a member of staff.

Parent/Guardian Consent Statement (This must be the legal guardian/parental responsibility for a child being looked after)

1) If it becomes necessary for the above-named young person to received medical treatment and I cannot be contacted to authorise this, I hereby give my general consent to any necessary medical treatment and authorise the leader in charge to sign any document required by the health authorities.
2) If the named-above young person is deemed unfit to participate in any part of the programme, or leaves an activity without permission, I agree to make immediate arrangements for them to leave the project site until agreed with the staff that they are fit to return.
3) I give permission for named-above child to go low-risk trips or excursions, such as visiting local venues, including transport to and from the venue where appropriate. Other high activities trips outside the local area will require an additional consent form.
4) I give permission for photographs, videos and other recorded information of my child to be used in publicity and evaluation materials.
5) I confirm that the information on this form is correct and I agree that the information can be used in accordance with CYN’s privacy statement (details above). I will inform CYN of any changes to these details.