NEW MEMBERS FORM Young Person`s Name: Young Persons

NEW MEMBERS FORM
http://stmaryswestham.org.uk/connect.html
Young Person’s Name:
Young Persons Date of Birth:
Young Persons Address:
Name and contact of parent/guardian:
Home:
Email:
Mobile:
Alternative emergency contact:
Are there any medical conditions or allergies group leaders should be aware of? (Please feel free
to discuss with Wendy Smith in confidence or attach any information to this form)
Use of Photographs – from time to time its nice to put up a display in the church of what the youth
group have been doing, are you happy for photographs of your child to be used for this purpose? (no
names will be put next to pictures)
YES/NO
How will the young person get home? In order to keep your young person safe we would prefer
parents/ guardians to collect their young person from the door, however we do appreciate that as
they get older some living more locally will walk home alone etc. Thank you.
Is your young person allowed to walk home alone?
Who is likely to collect your young person if not a parent (car share etc?)
During the summer term the youth group will be using the Pevensey Recreation Ground on club
nights. Leaders will accompany the young people from the church down the footpath behind the
church to the recreation ground. By your child attending the club we are assuming you are in
agreement with this activity.
Signed:
Relationship to young person:
Date