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Young People's Registration Form
This form is for young people who want to attend our youth groups or get support from our Brighton & Hove careers service.
You must be:
We need to ask you a few questions about yourself. This is for a few reasons, including:
We also ask some questions about yourself so we can let our funders know about the background of people accessing our youth services.
If you want to know more about the data we collect, please read our privacy policy.
Which area do you, the young person live in?*
Are you a young person, or are you a parent carer filling out this for your young person?*
About you the parent carer
Please confirm that you (the parent carer) agree to sharing your information with Amaze*
What is your relationship to the young person?*
Your first name*
Your last name*
Your email address*
Your mobile number*
Your gender*
Do you live at the same address as the young person?*
First line of your address*
Second line of your address
Town/City*
Postcode*
The rest of the form is for your young person to complete or together with you if they need support
Please confirm that you (the young person) agree to sharing your information with Amaze*
Tell us anything we need to know about so we can keep you safe and comfortable taking part in our activities e.g. allergies, online safety issues, safeguarding, bullying, sensory needs, distressed behaviour. You can share this here or you can write that we need to call you or your parent carer so you can tell us more.
Tell us a bit about you so we have an idea of what you like doing and what you want/need from us e.g. hobbies, interests, how you communicate.
Your contact details
Town/city*
If you want us to contact you through your parent or carer, you can put their contact details here instead of yours
Email address*
Mobile number*
Diversity Information
Your date of birth*
What is your gender?*
If not listed, how do you describe your gender?
What is the sex you were assigned at birth?*
What pronouns should we use for you?
What pronouns do you use?
What is your ethnicity?*
How do you describe your ethnicity?
What is your sexuality?
How do you describe your sexuality?
Please tell us your disabilities, long term health conditions or neurodivergence?*
Which project do you want to access?*
What is the name of your GP surgery?*
Your Emergency Contact
Who do you want us to contact in case you are involved in an emergency?
Their full name*
Their phone number*
What is their relationship to you?*
Consent to share data and images
If you are aged 14 or 15, we will also need your parent carer's permission. If you don't understand these questions or are not sure, select 'Don't know' and we can go through them when we meet.
We are funded by the NHS, you can find out more here.
Are you happy for us to share some anonymised information about you with the NHS?*
Amaze sometimes takes photos or videos at groups & events. Please read this [pdf 1mb] if you want to know more before you answer the questions below.
Are you happy for Amaze to use photos of you?
Are you happy for Amaze to use videos of you?
Are you happy for the photographer to use photos of you in their portfolio?