Level Youth Collective Register of Interest

Level Youth Collective

Please complete this form to register your interest in the Level Youth Collective. If you have any queries, please contact info@levelcentre.com for more information.

Young Person's Details

Name *

Street Name *

House name/number

City

Postal Code

Country

Does the young person have any medical conditions, allergies or disabilities we should know about? Or are there any activities that the young person cannot participate in? *

YesNo

If you answered ‘yes’, please use this space to provide details, including how we can help.

Parent/Guardian Contact Details

Please complete

Name *

Parent/Guardian phone number *

Email address of parent/guardian *

Emergency Contact Details

Please complete if different to parent/guardian's contact's details

Emergency contact name

Emergency contact phone number

Relationship of emergency contact to young person

Photo and Video Consent

We may occasionally take photographs and videos of LEVEL Centre activities which we may use for promotional purposes such as social media, website and brochures. Please tick ‘yes’ if you are happy to give your consent for this.

Please tick ‘yes’ if you are happy to give your consent for this. *

YesNoNote: if consent is not given, LEVEL Centre will not use any images of the young person taken during the activity

Schedule

The Level Youth Collective will be on Mondays from 5 - 6.30pm

How does the young person plan to travel to Level Centre? *

Does the young person enjoy creative activities? If yes, what creative activities have you tried before?

What is the young person hoping to achieve by joining this group? *

GDPR

To be completed by the parent/guardian

GDPR *Yes, I agree with the privacy policy and terms and conditions.

Level Youth Collective Register of Interest