Registration

Child's name *

First

Last

Gender *

Male
Female
Other
Prefer not to say

Date of Birth *

Your name *

First

Last

The primary contact – you – will have access to your child’s details on our online portal

Your e-mail *

Confirm Email

Your phone number *

Your alternative phone number

Your address *

Secondary contact name

First

Last

The optional secondary contact will also have access to your child’s details on our online portal

Secondary contact e-mail

Confirm Email

Secondary contact phone number

Secondary contact alternative phone number

Secondary contact address

Emergency contact *

First

Last

Please provide a different emergency contact in case you are not reachable – for example, when your child is on camp. This person will not have access to your child’s details through the online portal.

Emergency contact phone number *

Emergency contact alternative phone number

Emergency contact address *

Please enter any medical details we should know about

Please enter any allergies we should know about

Please enter any dietary requirements we should know about

Please enter any special needs or disabilities we should know about

Please enter names and dates of birth for any younger siblings who may wish to join the Group in the future (they will take priority on the waiting list)

Photograph consent

I give consent for photos/videos of my child to be taken, stored and shared internally in the meeting location, Scout websites and social media. I understand that if I later withdraw consent, previously published photos will not be able to be removed. (Regardless of this consent, the group/unit is not responsible for photos taken by other parties.)

Gift aid

Your membership subscriptions are eligible for Gift Aid – allowing us to reclaim 25p in every £1 from the government. Tick this box if you want to Gift Aid any donations made in the future to 1st Embsay and Eastby Scouts. You are declaring that you are a UK taxpayer and have paid at least the amount of Gift Aid claimed on all your donations in income Tax and/or Capital Gains Tax in each tax year.

Name of person donating via Gift Aid

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