Cookham Kids' Holiday Club (CKHC) Registration Form for Volunteers - 2019
Please use this form to register as a volunteer to help at our Holiday Club (29 July to 2 August 2019)

We take confidentiality seriously and will not share any of the information you provide without your consent.

Please note that junior helpers need to have completed Year 7 or above by the end of the 2019 summer term, i.e. at secondary school, and Year 9 or above to help on the Sports team

Email address *
Title
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
Postcode *
Your answer
Contact Number *
Your answer
Date of Birth *
Your answer
Days you can attend *
Required
Creche Places (for pre-school children)
In previous years we have tried to provide a creche for helpers' children who are pre-school age and therefore too young to attend the Club themselves. It has, however, proved very difficult to find someone to run this for us and we are therefore sorry that we cannot offer this for 2019 (unless there is someone reading this who is able to offer help?). Please note, any helpers' children who will have completed Reception class or above will be able to obtain a ticket and to register and attend the club.
Activities
We cannot guarantee roles at this stage but please indicate your preference for working in the areas below
Please tick as many as you like *
Required
If you are happy to work with a group of children (either as leader or assistant) please indicate if you have a preferred age group
Your answer
Do you have any experience of working with children? If so, please provide details *
Your answer
Safeguarding
As part of our safeguarding policy we need to ask if there is anything we need to be aware of which may affect you working with children, e.g. have you been convicted of a criminal offence, been cautioned by the police, found by a court to have caused significant harm to a person under 18, have you ever had a child removed from your care, have you been placed on the Child Protection Register?
Is there anything we need to be aware of which may affect you working with children *
If you answered Yes to the previous question, please provide details:
Your answer
Do you have a current DBS disclosure (if not we will contact you to arrange this where necessary) *
If yes please state number and date issued
Your answer
Referees
For each helper, we require 2 referees who have known you for 2 years or more. Please select 2 names from the list below if possible (no need to ask first). If the people below have not known you for at least 2 years, please provide contact details for two non-family members who we can contact about your offer of help.
Please select 2 referees from the list below *
Required
Referees: if you are not able to select 2 names from the list above please provide contact details (name, email address and phone number) for one or two non-family members who we can contact (we need 2 referees in total).
Your answer
Do you have any health conditions that we should be aware of (e.g. allergies, etc.)? *
If yes, please provide brief details
Your answer
Name and telephone number of next of kin *
Your answer
Do you have any medical qualifications? *
If Yes, please state what they are
Your answer
Training
We require all helpers to attend a short briefing session which will include some safeguarding training as well as providing you with useful information about the theme for the week and the activities planned. In addition, the Oxford Diocese requires all adult helpers (over 18) to complete some simple on-line basic safeguarding awareness training entitled ‘C0’ and for group leaders to also complete 'C1'. If you have already done either or both of these courses for CKHC 2018 or other church related activities, you do not need to repeat the course (it is advised it is repeated after 3 years).

Please note, for this year we will provide a separate training session for helpers who are 18 or under as at 31 August 2019 and it will be mandatory for them to attend this.
IF YOU ARE 19 OR OLDER as at 31 August 2019, please indicate which of the following training sessions you expect to attend (if you change your mind, just turn up at one of the other meetings but it is helpful to have a rough idea of numbers) *
IF YOU ARE 18 OR UNDER AS AT 31 AUGUST 2019, please confirm that you can attend the training session on Sunday 7 July at 4pm. *
Online Diocesan Safeguarding Training - please let us know whether you have already completed the Diocesan training or not (tick as many boxes as apply) *
Required
Data Protection
We take data protection and confidentiality seriously and will not use any of the information you have provided or share it with anyone without your consent.

Under the new data protection regulations (effective from 25 May 2018) we are obliged to obtain your consent to process the data provided for the purposes of the administration of Cookham Kids' Holiday Club. We would also like your consent to retain your contact details for the purposes of contacting you for future CKHC events, e.g. for volunteering next year.

Please confirm your consent below for us to process the data provided in this registration for the purposes of CKHC 2019 (parental consent is required for volunteers under 13 at the time of completing this form) *
If you are the parent of a volunteer under 13, please provide your name and email address or phone number
Your answer
Please confirm your consent below for us to retain your contact details for the purposes of contacting you in relation to future CKHC events, e.g. volunteering next year. *
We may send out materials relating to Church activities throughout the year; please indicate if you are happy for us to use the information in this registration for this purpose *
Thank you for volunteering!

Please SUBMIT to complete the registration

A copy of your responses will be emailed to the address you provided.
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