Escape Youth Services Membership Form
A form should be completed for each child. Young people under the age of 18 require parental/guardian consent before using our service. This form covers activities within our drop-in sessions and online activities. Separate consent forms will be required for groupwork, 1:1 work, trips and away days. Please inform us if the information on this form changes at any time as these details are required for emergencies.
Sign in to Google to save your progress. Learn more
Email *
Service Details

About Us:
Escape Youth Café is a drop-in facility for young people in Hawick and the surrounding area. It was set up in direct response to the identified needs of local young people.
Our vision is to enhance the lives of young people, building a positive future, by developing and sustaining a supportive service where young people can succeed and increasing the range, quantity and quality of youth-led provision.

Our service:
We provide a variety of services and activities for young people, both face-to-face and online, including age-appropriate issue-based work e.g. relationship education, sexual health, drugs and alcohol, health and well-being etc. Throughout the course of our work young people may approach workers regarding any of the issues mentioned above. We feel young people should be provided with appropriate information in order to make positive choices. Young people may also be signposted to specialist/external agencies to provide further information or support. We understand that some parents/guardians may have concerns regarding such issues and if you would like to discuss further please get in touch.
We work closely with the school and other youth provisions and agencies to ensure the needs of local youths are met. From time to time we may introduce new or alter existing services to our organisation and will notify all parents and members of such changes or additions, as well as other activities available in the area.

Consents for sessions and activities:
Please note that as a drop-in facility young people are permitted to leave the premises throughout sessions. If you do not wish your child to do so, please complete the relevant section appropriately on the membership form. During sessions, activities may also be offered nearby such as the local park etc, particularly over the summer months. Young people will be supervised at all times.
Additional consent forms will be required for activities out with the area and for organised events. These will be sent out prior to the activity or event before the young person can attend.

Ground Rules:
When young people first attend our service, they are asked to read and agree to Youth Cafe rules whilst in attendance. We follow a 3 strikes rule for inappropriate behaviour but depending on the severity of the action a young person may be asked to leave immediately. These rules also apply to any online activities.
Youth Cafe rules:
 Treat people, equipment and premises with respect
 No vandalism/swearing/bullying/violence
 Smoking/Alcohol/drugs prohibited
 Members are responsible for their personal possessions, (including any equipment such as mobile phones) whilst in the premises, Escape are not liable for any damages
 Warnings and exclusions for inappropriate behaviour are given at the duty youth workers discretion
***Covid-19 – all members must wear a face covering and follow additional hygiene and social distancing measures in place***

This list is not exclusive and may be altered from time to time to suit the needs of the service/young people, all members will be made aware of any changes. Failure to adhere to these rules may result in members being asked to leave or being excluded. Parents will be notified of any exclusions. Escape would appreciate your support in encouraging your child to abide by these rules.

Board of Trustees:
As a registered Charity, Escape is run by a group of volunteers who meet regularly to support the progression of the organisation and assist with fundraising. We are always looking for enthusiastic individuals who would like to support the project in any way and would encourage you to get in touch if interested.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Escape Youth Services. Report Abuse