South Gloucestershire Holiday Activities

These activities are free to all young people, aimed at young people receiving free school meals, ensuring no child goes hungry during the school holidays.

Your details

Emergency Contact Details

Emergency contact 1

Emergency contact 2

Equal opportunities

We want every young person to have the opportunity to fulfil their potential. This does not only mean that services should not discriminate against young people on grounds such as their gender, race, religion, sexuality or disability. It also means that services for young people should vary to meet their different needs, and by learning about who attends our clubs, we can do a better job of this!

I understand that by completing this form, the details I have provided above will be taken, saved and stored by Creative Youth Network for data protection reasons, namely to register me as a member of the Youth Centre, take part in activities at the Youth Centre and/or receive support by a Youth Worker at Creative Youth Network. I have been advised that if I want to know more detail about how Creative Youth Network deal with my information, I can ask to see the full Privacy Notice for Young People, Parents and Carers May 2018.

Parental/Guardian Consent Statement

This must be the legal guardian/parental responsibility for a child looked after.

1) If it becomes necessary for the above named child or young person to receive 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) I give permission for my child/young person to go on category one trips and excursions*.

*Category one trips are local low-risk activities such as visiting local venues e.g. the local park, including the transport to and from the venue where appropriate. Other higher risk activities such as canoeing or trips outside the local area e.g. Avon Ski Centre will require an additional signed consent form.
Please tick here if you do not want to give permission for category one trips and excursions

3) Privacy/Data Protection Statement
I agree that any information provided on this form, and during the project / course can be used by Creative Youth Network 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 and can ask to see the full Privacy Notice for Young People, Parents and Carers May 2018.

Thank you!