Member Details

When a young person signs up as member of the Youth Zone, we will ask for personal information, which we will process in accordance with all applicable data protection laws. We may collect sensitive personal information, for example, information relating to health, disability and/or ethnic background. We collect this information to ensure our facilities are safe and inclusive and we can target support to specific groups.

Member First Name* Member Last Name* Member Preferred Name Date of Birth* (DD-MM-YYYY) First Line of Address* Postcode* Member Phone Member Email School / College

Member Photo

Please provide a clear headshot that does not include any other people. This photo is only used to identify the member at the Youth Zone and will not be used for marketing or publicity purposes.

Sample Image

Member Details: continued

Gender Identity*
Which of the following terms best describes the member's current gender identity? Same as sex at birth*
Is the gender the member identifies with the same as their sex registered at birth? Ethnicity Religion Free School Meals* Food Allergies Care Experienced
Is the member ‘care experienced’? This includes, at any point in their life:

living with foster carers
living in a residential children's home
being looked after at home under a supervision order
living with friends or relatives in kinship care – either formally (arranged through the local authority or social services) or informally (arranged within the family)

Young Carer
A young carer helps to look after a relative with a disability, illness, mental health condition, or drug or alcohol problem.

All About Me

Disability / additional needs
Do you have any of the following? For any conditions or illnesses which are not lifelong or lasting or expected to last 12 months or more, even if not continuous, select other short term conditions.

Ability*
Do any of your conditions or illnesses reduce your ability to carry out day-to-day activities? Condition(s) Impairment(s)

My Needs

My likes My dislikes My triggers When upset, I may But you can help by How I feel about new places How I feel about other people How I like to communicate I would like to access the centre

My Plan

Personal evacuation plan
If you would not be able to leave the building unaided in an emergency, please tell us more about the support you may need. Medication
If you take any medication for your condition(s), please tell us anything we should be aware of.

More information
Please tell us anything else we should know about your condition(s) or additional needs. We may get in touch for more information and to confirm what support we are able to provide. If you have a safeguarding concern, please share this here, not below.

If the member has no disabilities or additional needs, press Next.

Parent/Guardian

This must be the person who fills out the Parent/Guardian Agreement at the end.

Name* Relationship* Phone* Email* Address (if different from above)

Additional Emergency Contact

Name Relationship Phone Email

Further Information

How did you hear about us? Reason for joining How will the member usually travel to the Youth Zone?

Membership Agreement

By signing up as a member you (and your parent/guardian for under 16s) agree that you may participate in activities on or off site and will follow the Youth Zone code of conduct.

Member agreement

The Youth Zone is part of the OnSide Network. Membership information is administered by OnSide (registered charity number 1125893).

I understand that my personal information may be:

used to provide me with services and carry out administration in relation to my membership;
used to communicate with me (and my parent/guardian) about services and my membership by email, phone, SMS, post or other means. We never sell your information and you can change your mind at any time by contacting us;
shared with OnSide, partners, funders and/or sponsors as required for the purposes of the development, coordination and support of the Youth Zone network. Contact us for a list. We will require third parties to keep this information confidential.

Member image

The Youth Zone requires a member photo for the purpose of security. This image will not be used for any other purpose.

In addition, images may be recorded at Youth Zone activities on or off site.

I agree that my image (in photos or videos) may be used for marketing and publicity purposes in printed publications, on social or traditional media, on the Youth Zone or OnSide website or by other organisations that want to promote the Youth Zone or OnSide (e.g. schools, funding bodies and private sector organisations). If we would like to use your image for other purposes, such as a large campaign or promotion, we will ask you (and your parent/guardian for under 16s) for permission.

Where there is a need to protect or support a young person, we may also share personal information with relevant agencies as required by law.

For further information about how we process your personal information, who we may share it with, and your rights, please read our Privacy Policy.

Confirmation Email

Tell us who is completing the application and payment so we can process it and send a confirmation email. First Name* Last Name* Email*

Become a Member

Member Details

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Member Photo

Member Details: continued

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All About Me

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My Needs

My Plan

Parent/Guardian

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Additional Emergency Contact

Further Information

Membership Agreement

Please review the highlighted errors.

Member agreement

Member image

Parent / guardian agreement for under 16s

Confirmation Email

Membership Details