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Y-Club Registration
This form is used to collect information about each young person who attends and will be used by YMCA Essex staff. The data you provide to us is securely stored. By submitting this form you confirm that you are happy for YMCA to contact you regarding Y-Club updates.
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First name *
last name *
Do you have any medical details, allergies or specific needs we should be aware of? *
Date of birth (day/month/year) *
What district do you live in? *
Have you attended any other YMCA youth clubs before? *
Do you give consent for photos to be taken and shared by YMCA, our partners & other third parties? Photos may be used for advertising, social media, press releases, reporting & any other youth related materials. 
 *
adult email *
adult phone number *
What School / College do you attend? *
What is the 1st line of your address (number & road)? *
What is your postcode? *
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