First Name

Last Name

First Name Required Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Which youth club group are you:* Which youth club group are you is Required

Junior: 8-12 Senior: 12-19

Date of birth:* Date of birth is Required

To which gender do they/you most identify?: To which gender do they/you most identify? is not valid

Male Female Trans-gender Non-binary Prefer not to say

Which of the following best represents the young person’s ethnicity?: Which of the following best represents the young person’s ethnicity? is not valid

English Black or African, Caribbean Asian or Asian British, Chinese Mixed ethnic group Other

Young person's email: Young person's email is not valid

Young person's mobile: Young person's mobile is not valid

I give consent for this young person to receive updates from NYCC directly about activities taking place at the centre and other related communications. *:* I give consent for this young person to receive updates from NYCC directly about activities taking place at the centre and other related communications. * is Required

Yes No

Medical conditions, disabilities and or/special educational needs Does this young person have a medical condition, disability and or/special educational need? *:* Medical conditions, disabilities and or/special educational needs Does this young person have a medical condition, disability and or/special educational need? * is Required

Yes No

Allergies and/or dietary requirements Does the young person have a food allergy, dietary requirement or non-food allergy? *:* Allergies and/or dietary requirements Does the young person have a food allergy, dietary requirement or non-food allergy? * is Required

Yes No

Medication Does the young person require medical treatment or need to take medication? *:* Medication Does the young person require medical treatment or need to take medication? * is Required

Yes No

Is the young person allergic to ANY medication (in case of an emergency situation)?:* Is the young person allergic to ANY medication (in case of an emergency situation)? is Required

Yes No

Is this young person currently in school, college or home-school:* Is this young person currently in school, college or home-school is Required

Please give the name of the school/college: Please give the name of the school/college is not valid

Do they already attend any other clubs or activities inside or outside of the NYCC?: Do they already attend any other clubs or activities inside or outside of the NYCC? is not valid

Yes No

If 'Yes', please give details.: If 'Yes', please give details. is not valid

<h3>Parent/Carer/Guardians Details</h3><p>You must be over 18 years old and have parental responsibility for the young person being registered to complete these details.</p>First name:* <h3>Parent/Carer/Guardians Details</h3><p>You must be over 18 years old and have parental responsibility for the young person being registered to complete these details.</p>First name is Required

Last name:* Last name is Required

Same address as young person's:* Same address as young person's is Required

Yes No

Relationship to young person:* Relationship to young person is Required

Mobile number: Mobile number is not valid

Telephone number: Telephone number is not valid

I agree to receive marketing from NYCC as a parent about our latest vital work, events, donation campaigns and opportunities to support us.:* I agree to receive marketing from NYCC as a parent about our latest vital work, events, donation campaigns and opportunities to support us. is Required

Yes No

<h3>GROUND RULES</h3> <p>All members of NYCC including young people, volunteers, members of staff help create a safe space for each other by agreeing to the following:</p> <ol> <li>Treating each other with respect.</li> <li>Respecting confidentiality.</li> <li>Welcoming and including new people to NYCC.</li> <li>Being understanding of each other’s differences.</li> <li>Not using sexually inappropriate language or innuendos.</li> <li>Not taking photos or making video calls during groups.</li> <li>Avoiding getting involved in gossip of any kind.</li> <li>Respect each other’s personal space and boundaries.</li> <li>Not using NYCC as a romantic space.</li> <li>Not swearing or using violent, bullying or abusive behaviour/language.</li> <li>Not using drugs and/or alcohol before or during sessions.</li> <li>Ensuring the only appropriate online content is being viewed/used.</li> <li>Not making assumptions about anyone’s gender identity or sexual orientation.</li> </ol> <p>These are our priority ground rules but there may be other behaviours not covered that may require action if NYCC is made unsafe as a result.</p>:* <h3>GROUND RULES</h3> <p>All members of NYCC including young people, volunteers, members of staff help create a safe space for each other by agreeing to the following:</p> <ol> <li>Treating each other with respect.</li> <li>Respecting confidentiality.</li> <li>Welcoming and including new people to NYCC.</li> <li>Being understanding of each other’s differences.</li> <li>Not using sexually inappropriate language or innuendos.</li> <li>Not taking photos or making video calls during groups.</li> <li>Avoiding getting involved in gossip of any kind.</li> <li>Respect each other’s personal space and boundaries.</li> <li>Not using NYCC as a romantic space.</li> <li>Not swearing or using violent, bullying or abusive behaviour/language.</li> <li>Not using drugs and/or alcohol before or during sessions.</li> <li>Ensuring the only appropriate online content is being viewed/used.</li> <li>Not making assumptions about anyone’s gender identity or sexual orientation.</li> </ol> <p>These are our priority ground rules but there may be other behaviours not covered that may require action if NYCC is made unsafe as a result.</p> is Required

I agree

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Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

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