LBA Volunteers/Workers Membership Form
This form is for LBA’s database. The form is entirely confidential and for company uses only. This information will not be divulged to any other company without your consent.
First Name
Your answer
Role
Choose roles that are relevant
Surname
Your answer
Full Address
Your answer
Post Code
Your answer
Contact Number
Mobile | Plus any other
Your answer
Skype
Your answer
Email(s)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Any Medicial information we should be aware of?
Your answer
Ethnicity
Are you registered disabled?
If yes to the questions above, what is your disability?
Your answer
Unique Tax Reference number (UTR)
If applicable
Your answer
Any other information
Your answer
Emergency Contact Details
Name
Your answer
Emergency Contact Details
What their relation to you?
Emergency Contact Details
email
Your answer
Emergency Contact Details
Phone number
Your answer
Parents Consent (If Under 18)
(eletric signature, so just type name)
Your answer
Terms & Conditions
1) You must uphold good practice and not tarnish your or LBA's reputation. 2) You may need your own insurance and if you do but dont currently have any you must be working towards it and will keep LBA updated. 3) By submitting this form you also confirm you take full responsibility for your tax and National Insurance contributions as a self-employed and in no way hold LBA accountable or liable for any payments you receive from LBA
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