WAITING LIST-Called to Serve: Altar Servers' Retreat- Under 18 Consent form.
The Altar Servers retreat is now full. Please complete the form to be added to our waiting list.
The Parent/Guardian details provided will be used as the first emergency contact and to communicate about the Retreat.
Second Emergency Contact Details
Please provide details of a second person to be contacted in case of an emergency. We will attempt to contact the first emergency contact before using the second contact provided.
Emergency Contact Name
Emergency Contact Mobile
Please provide the following details for each young person you are registering. To complete the registration details for more than one young person select "add another response" at the bottom of the box below.
Young persons details
Date of Birth
dd/mm/yyyy eg: 21/03/2010
Can the Young Person ride a mountain bike?
House name/Number and Street
Does the participant suffer from asthma, allergies, diabetes,
epilepsy or and other medical condition that may affect normal
Please give details of condition & treatment.
Does the participant have any special dietary needs or food allergies?
Please give details
For example vegetarian, nut allergy etc
Name of your Parish
Will you be attending as part of a group with a leader or as an individual?
Attending as part of a group
Attending as an individual
Name of your Parish Leader
Parish Leaders email
Parish Leaders Mobile number
The information you have provided in this form will be retained by the Kenelm Youth Trust (Charity Number
1144209) and shared with the Archdiocese of Birmingham ( Charity Number 234216) and
the group leader of your youth group and 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: email@example.com
I consent to my information being stored and used as detailed above
In the event that I cannot be contacted by ordinary means, I give permission and consent for my child/young person to receive any necessary medical treatment and authorise the group leader/person in charge to sign any medical documents required by the hospital authorities.
I consent to my child/young person receiving necessary medical treatment in the event I cannot be contacted.
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
My child and I consent to photographs and video's being used to share about the work of the Kenelm Youth Trust on our website, social media, publications and presentations.
If an error code appears and stops the form from being submitted, p
lease email firstname.lastname@example.org who will be able to assist you.