Young Hackney Membership Registration Form
Welcome to Young Hackney!

Due to the risk of covid-19 we have put in place health and safety measures to help reduce the risk transmission. There will be a limited capacity for the term time programme to ensure social distancing is maintained. If you would like your child to attend, you will need to pre-register them by completing this application form.

Please note important information below in relation to Covid-19:

- If you or a member of your household is feeling unwell or showing any symptoms of Covid-19 (fever/high temperature, dry cough, loss of taste or smell) please do not come to the hubs or playgrounds. Call your local GP or visit NHS online for further support.
- If you have been to the hubs or playgrounds and have a positive Covid -19 test result in your household please let us know.
- If you have been directed to self isolate please do not come to the hubs or playgrounds

Young Hackney Membership:

We hope to introduce you to new people, experiences and challenges and look forward to your involvement with Young Hackney now and in the future. Young Hackney staff can provide you with information, advice and guidance on a range of topics – for example, about your health, about careers or about education. We can help you with any difficulties you are having, whether this is at school, home, or with friends. In order to do this we need to hold some information about you.

By completing and signing this form you will also become a member of Young Hackney.

How we share information with other people?
The Data Protection Act 2018 and the General Data Protection Legislation govern the information we hold. This includes what information we hold, how we hold it and who we share it with. We would only share information about you when it is necessary. For example:

Talk to another professional in the service about your needs to develop an appropriate support package
Talk to a college/training provider or employer about you to help you get an interview
Talk to another agency (for example your school) that we are working with to help meet your needs

There are a few situations when we would have to tell someone, even without your permission. These are:
To prevent a crime taking place either now or in the future
If there is a risk of harm to you or others

If you are under 16 we need to know if your parent(s) or carer(s) are happy for you to be a member of Young Hackney as well as gaining consent for trips. They will also have to consent to data and information sharing.

The information you provide in this form will be kept and shared if necessary. If you would like to know what information we keep about you, please visit:
Please tick the checkboxes that apply to the young person *
Please indicate what youth hub you would like to attend? *
Are you or any of your family members shielding? If Yes, please provide further information below *
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