Just Youth (12-16s) Summer HAF

Just Youth is for young people aged 12 - 16 year olds (school year 7- year 11). Please fill out this booking form if you would like your child to attend our HAF Summer 2023 Provision. (Please Note: you need to fill out separate forms for siblings.)

Child's Name *

First

Last

Child's Gender *

Child's Date of Birth *

Child's Age *

Child's School *

Does your child have free school meals? *

Yes
No
Not Sure

This information is required for your child to attend the provision.

Child's Medical *

Asthma, Eczema, Medication, etc.

Child's Disabilities (Please State) *

This includes ADHD, Autism, Sensory Issues etc.

Dietary Requirements *

Please fill this information correctly so we are able to know in advance your child's dietary requirements

Food Allergies or Intolerences

Staff Awareness

Is there ANYTHING staff should be aware of about your child?

Address *

Please fill out your address including house number, road name, area, city and postcode

Main Contact Name *

First

Last

Relationship to Child *

Main Contact Telephone Number *

Main Contact Email

Additional Emergency Contact 1 *

First

Last

Please fill out an Additional Emergency Contact details. This person need to be different to the Main Contact

Additional Emergency Contact Relationship to Child *

Additional Emergency Contact Telephone Number *

Which Just Youth (12 - 16s) Provision Days would you like your child to attend? *

Just Young is for young people in Year 7 - Year 11 at School.

Consent *

I consent photos/videos of my child to be taken and used for YMCA marketing purposes, including website, marketing promotions and social media
I agree to my child/young person being transported in YMCA minibuses, private hire vehicles including coaches or public transport
I consent to be added to a Parents Whatsapp group using the main contact number provided above
I consent to the named child/young person receiving any emergency treatment whilst in the care of YMCA Sutton Coldfield, including dental, medical or surgical treatment including administration of anaesthetic. We will always follow the advice of the medical practitioner treating the named child/young person. (Every POSSIBLE EFFORT will be made to contact you and an emergency contact)

Please read each one and tick if you're happy to consent to this. By leaving it blank you are stating you DO NOT consent.

Young Person's Consent *

My child will be collected by someone over 18 each day
I consent that my child can make their own way home from YMCA Main Site B72 1LE or (Transport Points if Available)
I consent for my child to be sent text messages as well as the Main Contact about Just Youth Summer 2023 (e.g Daily Info, Reminders etc). Text messages will only be sent by Just Youth Senior Worker - Shiv.
Please Only Contact the Main Contact

Young Person's Telephone Number *