Flame 2025 (Over 18) Consent Form
Your Details
First name
Last name
Email
Mobile
Please enter your mobile number with no gaps.
Parish/ Group you are attending with.
If not travelling with a group or parish please put individual in this box.
Your Postcode
Do you suffer from asthma, allergies, diabetes,
epilepsy or and other medical condition that may affect normal
activity?
Yes
No
Please give details of condition & treatment.
Do you have any special dietary needs or food allergies?
Yes
No
Please give details
For example vegetarian, nut allergy etc
What geographical area is your preferred pick up area?
Birmingham
Banbury and Oxfordshire
Staffordshire
Kidderminster and Worcestershire
Coventry
Dudley and Wolverhampton
Lichfield and Walsall
Other
What geographical area pick up is your preferred area?
Next of Kin
Name:
Mobile Number:
Please enter the mobile number with no gaps.
Relationship to you.
CONSENT
The information you have provided in this form will be retained by the Kenelm Youth Trust. The information provided will be used for the purposes of communicating with you about the event you are registering for and other opportunities that might be of interest to you. This information will be stored securely for 3 years. If at any point you want this information deleted please email: kristi.doughty@kenelmyouthtrust.org.uk
I consent to my information being stored and used as detailed above
KYT send out email newsletters once or twice per month about opportunities for young people and those who work with them. It is one of our key ways of communicating the many great opportunities offered by the Trust.
You can unsubscribe or change your preferences at any time.
Please sign me up to the monthly newsletter
Media Consent
I consent to photographs and video's being used to share about the work of the Kenelm Youth Trust and the Archdiocese of Birmingham on our websites, social media, publications and presentations.