Impact Gamers - Arcade - Sign Up
Fill in the form to give consent for your child to come to Impact Gamers Arcade / Games Making club

Impact Gamers, St Stpehen's Church, Newton St, BD5 7BH
info@impactgamers.net
07952 228797
01274 900709

Email address *
Arcade Registration form
This form will register your child for a place at an Impact Gamers club but not guarantee a place. We will contact you back to confirm your place. Priority is given to students who previously attended or live locally.

Impact Gamers is based at St Stephen's Church Basement, Newton St, Bradford BD5 7BH

Name of Child *
Your answer
Date of Birth (aged 7 or over) *
MM
/
DD
/
YYYY
School Attended *
Your answer
Home Address *
Your answer
Group you'd like to attend *
Stay from 4:30-5:30pm for Games Making group *
Adult coming to the session with them *
Your answer
Contact Phone number for that adult (ideally mobile) *
Your answer
Emergency Contact Name and Relationship (if different to above)
Your answer
Emergency Contact Phone Number
Your answer
Doctor's details (Name and surgery)
Your answer
Medical Conditions (Write N/A for none) *
Your answer
Other comments, other younger siblings coming?
Your answer
Please read this and consent.
Impact Gamers
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.

Travel Arrangements
We expect you to be responsible for your child’s travel arrangements to and from the sessions. For any off site activity, we will arrange separate consent.

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.
Missing 3 sessions within 6 weeks may also jeopardise your child's place.

Confidentiality and Data Protection
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,

First Aid
You give consent for any first aid or emergency medical treatment

An responsible adult will need to stay during sessions.

This form will register your child for a place at an Impact Gamers club but not guarantee a place. We will contact you back to confirm your place. Priority is given to students who previously attended or live locally.

Impact Gamers is based at St Stephen's Church Basement, Newton St, Bradford BD5 7BH

I consent. Type your name below as a digital signature *
Your answer
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