Sign up form (Teen or Young Adult)

This form is to sign your young person up to join our ONLINE Teen Club sessons only and (if they wish to) access to our Teen Whatsapp chat group, Teen Discord group and the ASDFH gaming server.

If your young person would like to apply for a place at our teen clubs or young adult groups in Wokingham or West Berks AFTER lockdown, please read the information below.

Teen Club in Wokingham is full and we were running a waiting list. We can add your teen to our waiting list. They meet 2 Wednesday's a month in Emmbrook, Wokingham.

West Berks Teen Club has spaces, so we should be able to offer those places to you as soon as we can reopen sessions. They meet 1 Monday a month in Thatcham.

West Berks Young adult group (over 18's) has spaces available as soon as we reopen and meets 1 Monday a month in Newbury.

Wokingham Young adults group (over 18's) is being set up as a new group after lockdown. Wokingham young adults are joining the West Berks young adults online during lockdown. As soon as we can reopen sessions, we need young adults in Wokingham to work with us to set up our new group!

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* 1. I am interested in joining

West Berks Teen Club Online (12 - 18 years)

Wokingham Teen Club Online (12 to 18 years)

Young adults group Online (18 years or over)

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* 2. Young persons name

First name

Surname

I like to be called:

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* 3. Age of young person (please enter date of birth)

If you are over 18 and are completing this form for yourself, please ignore questions regarding parent/carer details.

Date

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* 4. Address details

Address

Postcode

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* 5. Parent/carer name

Please tell us what your relationship is (mum, dad, grandparent, carer etc)

First Name

Surname

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* 6. Parent/carer contact number is

Mobile

Landline

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* 7. Young persons contact number (if you would like to join whatsapp teen chat)

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* 8. School / college young person attends (leave blank if this is not applicable)

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* 9. Male / Female

Male

Female

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* 10. Parent/carer email address (or young persons email if you are completing this form yourself)

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* 11. Please give details of young persons disability or additional need (even if there is no formal diagnosis yet)

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* 12. How does your young person communicate/express emotions? (ie/ uses echolaic speech, withdraws if anxious, can stim if excited or upset, can become angry and shout if stressed)

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* 13. What else should we know to best support your child (any phobias, trigger words, difficulty turn taking, difficulty talking in a group etc)

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* 14. I give permission for this information to be shared with other staff/volunteers who are supporting the young people in these sessions.

Yes

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* 15. I give permission for my young person to be in photographs that may be taken during a session/online in zoom (these may be used on our Facebook page or given to funders - no young person will ever be named)

Yes

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* 16. I would like to be included in relevant emails sent to parents

Yes

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* 17. As a parent/carer I would like some extra support for myself

Yes

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* 18. My preferred support would be

Phone call (this can be weekly if required)

Text chat (this can be weekly if required)

Whatsapp chat (this can be weekly if required)

Video chat on FB Messenger or Zoom (this can be weekly if required)

I need a longer online appointment for help with financial difficulties, benefit claims (ie universal credit/PIP), form filling (like EHCP assessments)

If you have something you specifically need help with, please tell us here so that the right person can contact you

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* 19. By submitting this form, I agree that the young person & myself have read, discussed & agree to the following contract of behaviour when participating in our sessions:

1. RESPECT everyone in my club (LISTEN to others. No rudeness. Kind words only)

2. If I don't understand something, I will ask a member of staff.

3. If I am worried or upset by anything I see or hear during sessions (or within the teen chat groups), I will tell my parent/carer or a member of staff.

4. We don't allow bullying. I will be kind to others and I will not send anyone material that could be considered threatening, bullying, offensive or illegal.

5. We don't allow swearing or rude language.

6. Whilst I am participating online, I realise that I need to be dressed appropriately as though I was out in public.

7. The Activity Leaders supporting these sessions are Kerrie, Emilie, Donna, Jayne, Jack, Tracy, Briony and Rachael (we cover different sessions each). I will be introduced to the adults running my session.

8. All staff will keep their camera's switched on and will have ASD Family Help written after their name on Zoom. I can message them privately if I have any worries.

9. I will not give out any personal information online, such as my name, phone number or address & I will not reveal my passwords to anyone.

10. I will not arrange a face-to-face meeting with someone I meet online unless I have discussed this with my parents and/or group leader and am accompanied by a trusted adult.

11. I will be responsible for my behaviour when using the internet, including social media platforms, games and apps.

12. You must be aged 13 or over to sign up to a Viber, Discord or Facebook to connect with our chat groups. You must be aged 16 or over to sign up and download apps for WhatsApp or Zoom. If you are under 16, when using Zoom to meet with us online, please use a parents account OR join using ONLY the weblink (this means you do not download the Zoom app and the only information it asks you for is your name - enter your first name or a nickname that you tell us).

13. I understand that my behaviour and activity whilst connecting with other young people, staff & volunteers from ASD Family Help will be monitored and may be logged and can be made available to the Project Manager. I understand that these rules are designed to keep me safe and that if I choose not to follow them, ASD Family Help may contact my parents/carers.

14. If you have any questions or concerns please email Rachael (rachael@asdfamilyhelp.org).

15. PARENTS/CARERS: Whilst my young person is participating online, I realise that as their appropriate adult I also need to be aware of my language and appropriate dress as it could be possible for other young people to see or hear me in the background.

16. PARENTS/CARERS: I understand that this online environment is unusual & different to a regular session. Communication that happens during sessions normally would remain confidential with staff and would only be shared with the appropriate parent/carer concerned. Online however, it COULD be possible for other adults who are supporting their young people to overhear conversations/communication within online activities, which is unavoidable. We therefore ask all adults supporting their own young people to be mindful of and supportive of other people participating so that anything heard within online activities is not discussed or judged in your own homes. Any concerns must please only be raised with Rachael (Rachael@asdfamilyhelp.org).

Yes