Impact Gamers - 2020
Fill in the form to show interest and consent for your child to come to Impact Gamers [Updated 16 Dec 2019]
This form will register your child for a place at an Impact Gamers club but not guarantee a automatically place. We will contact you back to confirm your place. If over subscribed priority is given to students who we feel would benefit most or help benefit the mix of the group.
Play and Make - afterschool group for playing together and a little learning of IT and game design
GAME ON! - game making and some coding as a group, learning to work with others and make new friends
PEARS - coding groups where the young people work on an individual project to express their own thoughts and world view.
Impact Gamers is based at St Stephen's Church Basement, Newton St, Bradford BD5 7BH
or Adam on 07952 228797 for more details
Name of Student
Date of Birth
Courses you'd consider
Afterschool Play and Make (7-12yrs) - Mondays in term time @ St Stephens Church BD5 7BH 3-5pm
NOW FULL! PEARS Group A (9-16yrs) - Every Monday in term time @ St Stephens Church BD5 7BH 5-6:30pm
NOW FULL! PEARS Group B (9-16yrs)- Every Monday in term time @ St Stephens Church BD5 7BH 6:30-8pm
NOW FULL! Game On Group 7 - Seven Saturdays 10:30am-12pm @ 29 John St in Town : 18th Jan-8th Feb, 29th Feb-14th March
Game on Group 8 (8-11yrs) - Five Tuesdays 3:45pm-5:15pm @ St Stephens Church BD5 : 28th Jan-11th,Feb 25th-3rd March
NOW FULL! Game on Group 9 (10-16yrs) - Seven Tuesdays 6pm-7:15pm @ Scholemoor Beacon BD7 : 14th Jan-11th,Feb 25th-3rd March
I can make sure my child arrives safely (Or myself if over 16)
I would need help in with transport
Any disability, special need or learning condition
Parents/Carers/Workers Name/Names (If under 18)
Contact Phone number for above (ideally mobile)
Doctor's details (Name and surgery)
Medical Conditions (Write N/A for none)
Other comments ( What input the child could benefit from)
I'm happy for you to contact me about...
supporting impact gamers financially
news of our organisation
Please read this and consent.
Impact Gamers is a community interest company, who aim to inspire young people to make positive computer games. We run groups and events to inspire young people to grow in confidence and skills in computer use and programming. We make games as groups and individuals which are uploaded and shared online for the public to enjoy. Content made in the group belongs to Impact Gamers and we are able to use it to further our aim.
We expect you to be responsible for your child’s travel arrangements to and from the sessions, unless otherwise agreed.
Maintaining a place at Impact Gamers
Your child can stop attending at any point, but please let us know before you end their place. If the staff feel another group is more suitable or other issues arise from your child's place in a particular group switch or end placements.
Confidentiality and Data Protection
We will only use your details to contact you about your child's specific group information, unless you authorise us otherwise.
If young people wish to share information about a difficult part of their life, it will be handled sensitively but not necessarily in confidence. If a young person is, in our opinion, likely to come to some immediate or serious harm, we have a duty of care to disclose relevant details to the proper authorities and members of staff who need to know.
Information is stored on a computer only as long as is necessary.
CCTV is in use in the building, these images are for safety and security
Photos may be taken for publicity,
You give consent for any first aid or emergency medical treatment
Parents are welcome to stay during sessions.
I consent. Type your name below as a digital signature
A copy of your responses will be emailed to the address you provided.
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