Registration details

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* 1. Young Person's Full Name 

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* 2. Date of birth

Date / Time

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* 3. Address

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* 4. Town

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* 5. Postcode

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* 6. School Attended

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* 7. Parent/Guardian's Full Name

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* 8. Relationship to Young Person

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* 9. Home Tel Number

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* 10. Mobile Tel Number

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* 11. Email address

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* 12. Alternative Emergency Contact Name (this person will be contacted if we cannot get hold of the above in an emergency)

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* 13. Relationship to Young Person

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* 14. Tel Number

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* 15. Are there any access needs we may need to be aware of? (e.g. mobility)

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* 16. Is there anything we can do to support the young person's participation?

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* 17. Are there any medical conditions we may need to be aware of? (e.g. allergies, any regular medication taken)

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* 18. Please tick the boxes if you DO NOT consent to the following:

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* 19. You acknowledge that it is the parent/guardian's responsibility to update Wiltshire Creative with any change in contact details

Thank you for completing the Young Ambassadors registration form. 

The Take Part team will be in contact with you shortly.
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