Booking Form - Learning2Change Our World

Please complete all relevant sections and click Submit at the bottom of the form

Person Details

First Name

Last Name

Mobile

School Details

Name of School

Roll Number

County

School Phone

School Email

School Website

Additional Teacher Names (Alternative contact)

Teacher Name

Mobile Number

Participants

Group Info

Student Year Group	Overall number of Students
Overall number of Female Students Overall number of Students that identify as Other/Non-binary/trans-masc/trans-fem	Overall number of Male Students

Terms & Conditions

Booking: Your place will be reserved only when this booking form has been completed

Data Protection:

The personal information supplied through this booking form will be processed by ECO-UNESCO only in relation to the delivery of the products and services detailed above. Your personal information will be stored securely on our systems and be retained in line with our data retention policies.

Where the products or services detailed above are being provided to you at a reduced rate or at no cost through funding provided by a 3rd party, we may be required to provide the funder with some of the above information as evidence of how their funds were spent.

Yes, I consent

By ticking this box, you consent to ECO-UNESCO processing your personal information and providing it to 3rd parties where required

Policy on the use of photographs and video:
ECO-UNESCO may take and record images (both still and moving) and audio from our activities for both training and quality assurance, as well has promotion and evidence of our work.

Yes, I consent

By ticking this box, you are consenting on behalf of your organisation to ECO-UNESCO recording images and audio from the services detailed above and that you have previously obtained appropriate parental permission for the young people in your care to enable you to consent on their behalf.

Medical Assistance:
Should an incident occur, in the absence of another trained person, ECO-UNESCO staff, at their sole discretion, may elect to provide appropriate first aid assistance to any injured persons.

Yes, I consent

Please tick this box to indicate that you are authorising ECO-UNESCO to undertake appropriate first aid in the case of accident, injury, or emergency.

Participant Agreement

Please indicate that you have read and accepted the terms & conditions above

Yes, I understand and accept all the Terms and Conditions of this contract

Contact Information
Your Rights Under GDPR

Email Promotion	Newsletter	Leaflet
Word of Mouth	Internet (Please state which website below)	Other (Please specify below e.g. radio)