Your voice. Your town. Your culture. Your power to create change. Book your spot for Roots’ Youth Culture Vision Day for Telford & Wrekin.
Ready to help shape the cultural opportunities and future of Telford? This quick survey helps us to get back to you and confirm your spot on Saturday, 13th June (11am-4pm) and makes sure the day is accessible and comfortable for everyone. 
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1. About You
Full Name *
Preferred name / pronouns (optional)
Age *
Mobile number (for confirmation & updates) *
Email address (for confirmation & updates) *
Parent/guardian contact name (Only required for under-18s)
Parent/guardian contact email (Only required for under-18s)
How did you hear about Vision Day? *
Please provide the name of the organisation (e.g., School or Youth Group) that encouraged or referred you to attend the Vision Day:
2. Why You Want to Come 
What made you sign up for the Vision Day? (Select all that apply)
What do you hope will happen as a result of this day?
3. Commitment & Follow-Up 
Can you confirm you’ll attend from 11am to 4pm on Saturday 13th June? *
If you selected 'arrive late / leave early' above, please say when:
If you need a lift or transport support, please tick: *
Would you like to be part of the Youth Culture Ambassadors follow-up group after the event? *
4. Accessibility & Inclusion
I’d like materials provided in:
Clear selection
If you selected 'Other' for materials, please specify:
I need the following support during the day: (Select all that apply)
If you have an 'Other access need', please specify:
I will be accompanied by a support worker / carer / service animal
Clear selection
Lunch and snacks are provided — please tell us if you have any dietary needs: (Select all that apply) *
Required
If you have food allergies or intolerances, please specify:
Any other requests or things you’d like us to know to help you feel comfortable on the day?
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