Youth Walk December 2018
Saturday 8 December
3.00pm to 10pm to/from Amersham train station
Open to 13-18 years olds
Walk in London & enjoy the Christmas lights

Dinner on the go, NightFever event @ St Patrick’s Church, Free of charge

Organised by the
South East Bucks Pastoral Area
Event Leaders: Fr Alessandro and Brian Shelley

REGISTRATION
Please complete one on-line form for each young person who will attend.

Click on the line below the question and a solid line will appear, where you then type your response.

Young person's name - FIRST name *
Your answer
Young person's name - SURNAME *
Your answer
Young person's age *
on Sunday 8th December 2018
Your answer
Your parish *
Youth Walk London '18 is a Pastoral Area-wide event.
Your answer
Emergency Contact Details: Parent/Guardian name and contact number during the event (mobile & home numbers) *
Your answer
Parent/Guardian's email address *
Your answer
RETENTION OF DATA
Information given will be used solely for the purpose for which it was given. It will be held confidentially, updated when appropriate, & destroyed when no longer required in line with the Northampton Diocese Privacy Statement.
You may keep my email address for future invitations to youth activities *
PARENT/GUARDIAN CONSENTS (Under 18 years)
ALL boxes must be ticked *
Required
Name of parent/guardian giving consent *
including response to Data Retention
Your answer
Date consent given *
MM
/
DD
/
YYYY
Any food allergies or medical alerts of which we should be aware? *
Please state 'none' if it is so! If yes, and you feel it is necessary, please provide the name and phone number of your child's doctor.
Your answer
YOUNG PERSON'S CONSENTS
CODE OF CONDUCT FOR THE YOUNG PEOPLE We ask those attending Youth Walk London '18: *
ALL boxes must be ticked.
Required
MOBILE PHONE number for on the night *
For safety on the night of Youth Walk London '18 we ask to have the young person's mobile phone number. This will be shared with only the DBS-checked chaperones on the night via password protected (both) document and mobile phones. This information will be destroyed after the event and will be used for no other purpose. Please supply your (young person) mobile phone number. If you have any concerns on this, please write them below alongside the phone number or without the phone number.
Your answer
CONSENT GIVER: Name of young person *
Parent undertakes that they have shown their child this online consent form and the young person is the one giving this consent to the Code of Conduct and sharing of their mobile phone number.
Your answer
Date consent given *
to the above Code of Conduct.
MM
/
DD
/
YYYY
AVAILABILITY TO HELP
I am available to help and attend this event, please get in touch with me. Please give any extra information below.
Your answer
NOTES/QUESTIONS
Please make a note here if you have any questions and one of the organizers will be in touch. We look forward to a fun evening and are delighted your son or daughter will be joining us.
Your answer
THANK YOU for registering
As you have registered online you do not need to print out the booking form. Please ensure you click 'Submit' at the bottom - you will then get a Thank You screen.
Submit
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