Radical Hearts, Open Minds

Step 1 of 4 – Radical Hearts, Open Minds – Unaccompanied 11-18s

25%

This form will take around 7-10 minutes to complete. You will need:

– contact information

– contact information for an emergency contact during the event

– a recent photograph if you don’t want their image to be used for publicity purposes

The event will be free for under 18s and will run between 10am and 4pm. The event will be for all ages. There will be lunch and refreshments provided.

Consent and Information

Please complete this form by the deadline stated in your invitation mailing.

Please read the guidance and complete the form as requested. This Information and Consent form covers information required for insurance purposes and enables the effective planning and running of events.

This form will be handled, and the data will be stored, in electronic and paper forms in accordance with BYM Polices.

All participants need to agree to abide by the stated community agreement during the event, and accept responsibility for the consequences of any breaking of this community agreement (which may include being asked to leave the event).

Event Location(Required)

Name(Required)

First Last

Age

Phone

Email(Required)

Address(Required)

Street Address Address Line 2 City County Post Code

Area Meeting(Required)

Participant Needs

This helps us plan for or be aware of any needs you may have and how this might affect the support we provide and our facilitation at the event. With health conditions this means that if you are taken ill we have the appropriate information to hand to health care professionals.

Dietary Preference(Required)

Dietary Requirements(Required)

None

Diabetic

Food Allergies

Gluten Free

Dairy Free

Low-Fat

Other Special Diet

Additional Details

Please Provide any additional information about your allergies or preferences. e.g. is it an anaphylactic allergy? Is it airborne, contact or consumption? Please note that we cannot guarantee an allergen-free environment. If there are any sensory restrictions, it’s really helpful to indicate what types of food they are most comfortable with, as well as those that they can’t eat.

Emergency Contact

This information enables us to contact those who need informing in the event of an emergency.

EC Name(Required)

First Last

EC Mobile Phone(Required)

EC Landline Phone

EC Email(Required)

EC Address(Required)

Street Address Address Line 2 City County Post Code

Use of Data

In accordance with the UK Data Protection legislation and EU General Data Protection Regulation, permission must be granted by the parent/guardians or participant (if over 18) before any images may be taken and used, and for how the personal data can be used.

Quakers in Britain uses photography and video to attract new members, encourage people to take part in our activities and contribute to our funds.

Please indicate whether you give your consent for videos, images and audio of you/your child/ward to be used for these purposes in all of the following: print, website, e-books, other electronic formats and social media (Facebook, Twitter, etc.).

We do not identify people by name or meeting without specific, prior permission. We will not identify children and young people under the age of 18 by name, local meeting or where they live.

Some images or recordings may be kept permanently once they are published and archived by the organisation.

We may use images on collaborative work with other organisations e.g. Woodbrooke.

These will be the copyright of Britain Yearly Meeting (the legal name for Quakers in Britain), and any other intellectual property which arises in the recordings will also belong to Britain Yearly Meeting.

I can ask Quakers in Britain to stop using my images at any time, in which case they will not be used in future publications but may continue to appear in publications already in circulation (contact BYM Data Safety Group to discuss at datasafety@quaker.org.uk)

I can complain about the use of my image/audio by contacting Quakers in Britain Data Safety Group at datasafety@quaker.org.uk

Image Consent(Required)

Do you actively consent to the the participant’s image being used under the above conditions?

Should you wish to withdraw your consent at any time, please contact: qladmin@quaker.org.uk

Yes

Video Consent(Required)

Do you actively consent to audio/video recordings the participant’s being used under the above conditions?

Should you wish to withdraw your consent at any time, please contact: qladmin@quaker.org.uk

Yes

Picture

We need a record of what you look like, this enables us to delete any images taken of them during the event and/or ensure they are not in audio/video recordings.

Please upload a photo. If you need to send any other photos, send them directly to qladmin@quaker.org.uk

Max. file size: 32 MB.

Data Consent(Required)
Do you actively consent to the contact information you have provided being used to send promotional information about future events and opportunities?
Should you wish to withdraw your consent at any time, please contact: qladmin@quaker.org.uk

Yes

No

QForms YCF

Online forms and surveys from quaker.org.uk

Radical Hearts, Open Minds – Unaccompanied 11-18s