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About us
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Meet the Team
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Youth Club Member Registration Form
Registration form for Youth Club members.
Young Persons Name
(Required)
First
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Gender
(Required)
Male
Female
Other
Home Address
(Required)
Street Address
Postal Code
Ethnicity
(Required)
White
Mixed/Multiple ethnic groups
Asian/Asian British
Black/African/Caribbean/Black British
Other ethnic group
Prefer not to say
Religion
(Required)
Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
Any other religion
No religion
Prefer not to say
Emergency Contact Details
Emergency Contact Name
(Required)
First
Last
Emergency Contact Phone
(Required)
Additional Information
Please provide details of any special educational needs, disabilities, medical issues, or additional support requirements that we should know about to help us make reasonable adjustments and offer appropriate support
Is the child eligible for free school meals?
(Required)
This information helps us understand if additional support may be available.
Yes
No
Prefer not to say
Does the child or young person have lived experience of any of the following?
(Required)
This information helps us understand if any additional support is available. Please select all that apply.
Select All
LGBTQIA+
Care Experienced
SEND
Asylum Seeker
Young Carer
Young Offender
None of the above / prefer not to say
Consent and Terms and Conditions
Photo/Video Consent: By ticking the box below, you consent to the use of photographs and/or videos taken during sessions for the following purposes: social media, our official website and grant/funding applications and due-dilligence. You understand that these images/videos may be publicly shared. If you do not wish to be included in any of the above, please uncheck this box.
You may change your consent at any time by contacting hello@thebronte.org
I consent to the use of my images/videos for the purposes stated above.
I do not consent to the use of my images/videos for the purposes stated above.
Do you consent to your information, and/or your child's information, being shared with delivery partners when necessary?
(Required)
You may change your consent at any time by contacting hello@thebronte.org.
I agree.
I disagree.
Behavioural Code
(Required)
I (or my child) agree to follow The Brontes behavioural code, as well as all safety rules and instructions, to ensure that The Bronte’s staff and volunteers can maintain a safe environment for me/my child and others.
Medical Treatment
(Required)
I (or my child) consent to receive any necessary medical treatment in the event of an emergency.
Future Changes
(Required)
I agree to inform The Bronte of any changes to the information provided in this form.
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.