Activity Registration Form

Please complete one for each participant.

Activity

Activity Date

Participant Details

Firstname

Surname

Phone

Where You Live

Street Address

Address Line 2

Town/City

County

Postcode

Date of Birth

DOB

Useful Info

Gender or Pronoun

Mobility Needs

Communication Needs

Medical & Emergency Contact

Useful Medical Information

Emergency Contact

Emergency Phone

Emergency Treatment

EMERGENCY TREATMENT: In the case of an emergency, and in the event that I am unable to give consent myself, I give Hands of Hope permission to use their judgment in obtaining any medical attention they consider necessary. I consent to a medical specialist being contacted in a medical emergency. To the best of my knowledge I have declared all known medical conditions which may affect my ability to carry out my volunteering role(s) and I will advise Hands of Hope if my circumstances change. I acknowledge my medical information will be kept on file at Hands of Hope for the duration of my volunteering.

Consents

GDPR Consent

I agree to the processing of my data in accordance with Hands of Hope's Privacy Policy.

Photo Consent

I consent to staff taking photos and using them for the charity's Outcomes Reports.

Photo Consent

I consent to staff taking photos and using them to advertise and promote the charity's work.

And finally...

Anything else you'd like us to know?

How did you hear about this activity?

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