Register to use our community neighbourhood centres

Community Neighbourhood Centres - Registration form

Personal details

Title
Name
<b>Name</b>
First
Last
How do you identify your gender? (tick all that apply)

Emergency contact details

Name
<b>Name</b>
First
Last

Equalities monitoring

What's your ethnicity?
Do you have a disability or long term health condition?
If yes, please select (tick all that apply)

Communication consent

There may be times we need to contact you about activities you've registered for and one-off events. This may include using emails to provide updates on new developments at the centres and the use of text messaging to send you reminders, cancellation and activity feedback.
Please select one

Photo consent

We host lots of events and we often take pictures/videos that are later used in newsletters, reports, our website, publicity articles for press and funding applications amongst other things. If you are happy for us to use your picture please let us know below.
Please select one

Data protection statement and agreement

The information that we are collecting on this form will be securely stored in our database so that we can monitor the users at our Community Neighbourhood Centres. Your information will never be passed onto a third party unless we have obtained your prior consent. By submitting this form you are agreeing to us using your information as outlined above.

How will we use your data?

Information collected on this form will be to register you for activities in our community centres. We collect and process your data with your consent. We also record demographic information to demonstrate that our service is reaching our target audience and that resources are directed to the local community. We will not share your personal information to any third party organisations for marketing purposes. We only share anonymised statistical data with our funders for monitoring purposes. We may share your information with the emergency services in the event of an emergency, All information will be stored securely on our encrypted database. For adults we will store this for 6 years and for children 3 years after your child has turned 18. To find out more about how your information is used by us please read our privacy notice.

Add a Child?

Child Details

Personal details of child/young person

Name
<b>Name</b>
First
Last
Address
How do they identify their gender? (tick all that apply)

Equalities monitoring of child/young person

What is their ethnicity?
Do they have a disability or a long term health condition?