Forms home Youth service registration Thank you for your interest in the Redbridge Youth Service. To attend any of our sessions, you need to register by completing this form. We have a number of teams in the service, please tick the Youth Centre or project you are most interested in joining, so that we know who to send your form to. We deliver workshops throughout the year offering you the opportunity to enhance your skills and knowledge, helping you prepare for adulthood as well as the chance to make new friends. Come along and take part in a range of activities, share your thoughts and get your voice heard. Looking forward to hearing from you.New memberWhat Youth Centre or project are you interested in?* Duke of Edinburgh’s Award for 14 to 24 years old Hainault Youth Centre for 11 to 18 years old Monday night group for young people with additional needs - 13 to 24 years old Youth Involvement/Youth Council Children in care councils Loxford Youth Centre National Citizens Service (NCS) Duke of Edinburgh’s Award for 14 to 24 years olds Doing your #DofE is a chance to discover new interests, have fun, get fit, gain skills and achieve an Award that will help you stand out in job and uni applications. If you’re in year 9, 10, 11 or 6th Form, you can sign up now.Hainault Youth Centre for 11 to 18 year olds We offer a wide range of positive activities for 11 to 18-year olds, based on weekly themes. Activities include basketball, football, badminton, cricket, pool & table tennis, learning to cook, arts & crafts, team games & competitions. Monday night group (for young people with additional needs) - 13 to 24 year olds Sessions and activities are designed to meet the needs of young people with additional needs, offering a mix of group activities including cooking, creative arts, sports, discussions and workshops, as well the opportunity to socialise and meet new people.Youth Involvement/Youth Council We want to give young people aged 11 to 19 in Redbridge a say on the issues that matter to them and a chance to have their voice heard with decision makers. You can do that by joining Youth Council or as an Ambassador for Child Friendly Redbridge. Children in care councils The Children in Care Councils and its various projects are specifically designed to meet the needs of children and young people, over the age of 11, who are looked after by the London Borough Redbridge.Loxford Youth Centre We offer a targeted range of activities for 11-18 year olds to help build confidence, motivation, fitness and encourage positive life choices. Activities include homework club, music production, cooking and Boxup.National Citizens Service (NCS) A year long project for young people in year 11 & 12 to take part of activities, community action project and life skills.What activities are you interested in? Sports Life skill workshops: Cooking session, Healthy eating, Money management, CV prep Issue based workshops: Relationships, Sexual health, Drugs & alcohol awareness, Gambling, Internet safety - cyber bullying Art and media: Animation, Photography, Music, Lyric writing, Crafts, Painting, Drawing Other activities: Games console, Board games, Socialising, Homework If you have answered 'sports', please specify* Football Badminton Basketball Table tennis Pool table All sports Young persons detailsIf you are under 16 this must be the person who fills out the agreement and consent below.First name* Last name* Date of birth* DD slash MM slash YYYY Email* Gender Female Male Prefer not to say Address of young person* Address Line 1 Address Line 2 City Postal code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone number*Mobile or home landlineSchool, college or other* Please indicate if your young person is an independent traveller and has your consent to:Leave the session at any time* Yes No Travel home on their own* Yes No Name of emergency contact* This is usually a parent/carer/guardian and must be 18 years old & over.Emergency contact number* This is usually a parent/carer/guardian and must be 18 years old & over.Information to support you to participate safely and enjoy the sessionsDo you have any food allergies or dietary requirements?* Yes No If you have answered 'yes', please specify* Do you have any medical or disability needs?* Learning support/behaviour Dyslexia/dyspraxia Autism ADD/ADHD Needs extra support Mild moderate or severe learning difficulties/disabilities Speech & language disability Allergies Other None If you have answered 'other', please specify Please give a brief detail of disability, additional needs or medical conditions.We may get in touch for more information before your visit.Do you need any support at school or college?* Yes No If you have answered 'yes', please specify Would you like to tell us anything else?EthnicityPlease tick the appropriate box below. We ask for information on your ethnicity to enable us to develop targeted services in the future and ensure that we are working with young people throughout our local population.Asian Indian Pakistani Bangladeshi Any other Asian Black Black Caribbean Black African Any other Black Chinese Chinese Mixed Mixed White White British White Non-British Other Other Ethnicity Unclassified If you have answered 'other' in any of the above sections, please specify Agreement and consentUse of your data* Details provided on this form and your involvement in youth activities will be stored and monitored by the Youth Service. We may share your information with the Council’s internal departments so they can carry out their statutory roles and support our service (eg: social care, housing, Complaints Team, Business Intelligence Team, Corporate Finance Team, Legal Services Department, Information Management Team.) Details provided on this form will be used for a database mailing list to send me information about Youth Service and LBR activities. I understand that the data will be held in line with data protection legislation. Please read and click to acknowledge your consentLondon Borough of Redbridge (LBR) recognises the need to ensure the welfare and safety of all young and vulnerable people who participate in activities. In accordance with data protection legislation, images, photographs, video or other images will not be published of young or vulnerable people without the consent of the parents/carers and participants over 18. LBR will take all possible steps to ensure these images are used solely for the purposes they are intended.* I do give consent I do not give consent I consent for photographs or videos of this venture, to be used in LBR publicity material including but not limited to the LBR website, Facebook, displays and promotional material. I am aware I can withdraw consent by request. I understand that once a photograph or film is uploaded to a website or a social network site this may be viewed by any child/young person or adult. I understand that my membership and attendance may be terminated if I do not behave in a socially acceptable manner. Membership fees and charges* I understand that membership fees and charges are used to subsidise the programme on offer for young people. In the event of any surplus, the Service reserves the right to roll over to the next financial year and spend on activities for young people. (Some projects are currently funded & free to attend) Privacy* I am aware that the London Borough of Redbridge Privacy Notice can be viewed at the link below.London Borough of Redbridge Privacy NoticePerson completing the formYour name* Date of completion* MM slash DD slash YYYY
