Registration Form


To confirm your place at Base Camp, please carefully fill in the form below. If you have any questions please contact us.

* - this field is compulsory

Firstname of young person: *
Surname of young person: *

Date of Birth:*
School Year Group:*


Parent or Carer name*
Relationship to young person*
Address*


Postcode*
Home telephone number
Mobile number*
Email Address*

For your child's safety and protection, we need at least one additional telephone number. This may be the phone number of another relative or a close family friend. Please list the phone number(s) and who they belong to below:*


Which school does the young person attend?
Does the young person have any allergies, dietary requirements, medical condition(s), special needs or disabilities we should be aware of?
Please tick the boxes below to say you agree with each statement:

* I give permission for any base camp leader to liaise and share information as required with medical staff over any essential medical treatment that my child may need, if it is not possible for me to be contacted immediately.**

* Information from this form will be securely stored on computer

* My child is expected to behave in an appropriate manner, and I agree to come and collect them from any meeting or activity at my expense if, in the opinion of a base camp leader, their behaviour is unacceptable or endangering themselves or others.

Unnamed photos and videos of my child may be used in publicity for Base Camp.

*I will let Base Camp know if any of the contact information above changes in the future.

Your name:*

**Note: There is no legal provision for parents to delegate the right to consent to a child's medical treatment. A child who is able to understand the issues involved in a particular treatment is legally entitled to give their own consent. For most young people this would apply to treatment for minor injuries or ailments. If your child needed more serious medical treatment, the doctor would normally need to get your consent (which could be verbal consent through a phone call) before giving treatment - although urgent life-saving treatment would not be delayed by this requirement. Nonetheless, it can be helpful for medical staff to know that the parent is happy for a youth project leader to discuss decisions relating to the child, and to sign relevant documents relating to treatment.