'Fruits of the Earth' Young Adult Retreat Day

Fruits of the Earth Jam Retreat: 19th of September 2026

First name

Last name

Mobile

Your date of birth

Name of your Parish

Please include Parish name and area, for example: St Mary, Willenhall.

Please let us know of any dietary needs or allergies that may affect you taking part in the event.

Please let us know of any medical details that we may need to know about.

Emergency Contact details: In case of an emergency, please provide details of your next of kin who we can contact.

Next of Kin

Relationship to you

Next of Kin contact number

How your data is used and stored

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 training 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

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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.

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Media Consent

I give permission for photographs and video of my child to be used for the purposes of promoting the work of the Kenelm Youth Trust on social media, our website and other promotional materials.

I consent