Fearless/ Limitless- Leaders Form- November 2025
Leaders Details
First name
Last name
Email
Mobile
Your Parish/Youth Group
Do you hold a current up to date DBS?
Yes
No
Your DBS number
Emergency Contact Details
In case of an emergency, please provide an emergency contact for yourself.
Emergency Contact Name
Emergency Contact Mobile
Medical and Dietary needs
Do you have any medical conditions that we will need to be aware of for when you are attending the Fearless Retreat?
Yes
No
Please give details
Do you have any special dietary needs or food allergies?
Yes
No
Please provide details
Contribution towards meals
The cost to the Kenelm Youth Trust for leaders meals is £30 per leader. Anything you are able to offer to help cover these costs would be really welcome. If you would like to make a contribution towards meals, an email will be sent to you with how this contribution can be made. Please do not feel obliged to contribute if you are unable to. We appreciate the time you are committing to bring your youth group to Fearless.
Would you like to make a contribution towards meals?
Yes
No
CONSENT
The information you have provided in this form will be retained by the Kenelm Youth Trust 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: 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 on our website, social media, publications and presentations.
If an error code appears and stops the form from being submitted, p
lease email kristi.doughty@kenelmyouthtrust.com who will be able to assist you.