Totnes Youth Leisure Night - Registration Form:
This form will need to be filled out by the Parents or Carers of the young people wishing to attend the Totnes Youth Leisure Night. The Totnes Youth Leisure Night will take place on Friday evenings (every 1st and 3rd Friday of the month) 6pm until 8pm at Totnes Leisure Centre. Sessions are available for young people aged 11 - 18 years.
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Email *
Young Person's Forename: *
Young Person's Surname: *
DOB: *
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Address: *
Postcode: *
Does your young person have any medical needs or allergies? *
Does your young person have any disabilities? If so, how can we support them in the Youth Leisure Night session?
Youth Leisure Night Code of Conduct - Please read:

General Expectations:

·       Respect yourself, the space, staff, other young people and centre users, and equipment.

·       Make everyone feel welcome and respect diversity.

·       Treat others as you would like to be treated.

·       Take responsibility for your actions. 

·       Abide by the Leisure Centre rules.

·       If you leave the session at any time you cannot re-enter that evening.

·       Any incidence of disruptive behaviour or violence, either towards staff or other centre users or young people, will be dealt with by staff and if necessary parents/ carers or the police will be informed.

 *
Required
Gym Access Questions:
Please answer the questions below so that your young person will be able to access the Leisure Centre Gym. An additional Induction will need to take place at the session by the Gym Instructor. 
Does your young person have any of the following *
Required
Has anyone in your family had a heart problem when they were young? *
Has your young person ever undergone surgery? *
Is your young person currently feeling unwell? *
Is your young person currently receiving treatment from a GP or Hospital Consultant? *
Is your young person currently on any medication? *
Does your child have a disability or impairment? *
If you have answered yes to any of the above questions, please provide details here: *
If your young person has health conditions, it may be recommended that they visit a doctor before participating in the Gym session. Please let us know if your young person's health changes at anytime.

I have read, understood and completed this questionnaire for my young person to the best of my knowledge. I understand that my young person uses the facilities at their own risk:
 *
Swimming Pool Access:
Only young people who can swim will be able to access the Swimming Pool. Lifeguards will be present at all times during the activity.
My young person is able to swim: *
I give consent for my young person to access the swimming pool: *
I give consent: *
Required
Privacy Statement: By signing here, you are consenting for Fusion to hold all data given, including all activity and engagement with Fusion Centres and website such as booking and information regarding membership. Your data will be kept securely and removed from our systems when no longer required. You have the right to access your data and withdraw your consent at anytime. 

I would like Fusion to contact me about the following offers and news:
Is there anything else we need to know about your young person?: *
Parent / Carer (Emergency Contact) Name: *
Parent/Carer (Emergency Contact) Number: *
Would you like the above mobile number to be added to the Totnes Youth Leisure Night text reminder service? This group will remind you when the Youth Leisure Nights are taking place and let you know about any up and coming TRAYE activities. *
Required
Thank you for taking the time to fill out this form.
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This form was created inside of Totnes Rural Area Youth Engagement (TRAYE) Project. Report Abuse
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