Skylark IX in Stitches- Sign Up Form
***IMPORTANT MESSAGE, PLEASE READ before continuing***

Hello there and welcome to our sign up sheet! If you need any support to fill this in. Please don't hesitate to get in touch with us ASAP (Not a problem).

The Skylark IX Recovery Trust are running "Skylark IX In Stitches" group for adults aged 18+ in West Dunbartonshire in response to raised interest for an adults group after our young person group held over the summer holidays as part of our community engagement programme. This group will take place on Tuesdays, starting the 28th September, 6pm-8pm at the Alternatives Office in Dumbarton (1/3 Quay Street) week one then Lennox Evangelical Church, Risk st, Dumbarton from then onwards. PLEASE NOTE Tuesday 5th October, the group will NOT BE ON for the October holidays.

We would be keen for you to take part in the evaluation of our programme some time later in the year to give us feedback and ideas, and to help support further projects and funding for the Trust to continue our work with you like this. We would really appreciate your input, if you can tick the box at the end of the form to let us know if you're happy to take part please.

If you are needing support with travelling to this location there is a section in the form where you can notify us of this and we will get in touch to support you. In addition, for those with accessibility issues, there are stairs in the building with 26 steps and no lift unfortunately. Lennox evangelical church however does have disabled access.

Please ensure you provide the correct details for us to correspond with you. If we cannot connect with you at least 24 hours prior to your session, we will assume you no longer can attend your space and it will be filled. I am sure you will understand for health and safety reasons the importance of this and for us to ensure our attendees to meet current government COVID-19 guidelines.

Covid-19 Safety:
We have undertaken risk assessment of the activities and have precautions in place for safety, such as providing hand sanitiser and face masks for participants on arrival, and limiting numbers to reduce the risk of spread.
If you or anyone in your household are showing symptoms of Covid-19, DO NOT attend the group unless you have received a negative test result, in accordance to government guidelines.


GDPR Policy:
The information we are gathering is required by our team to ensure we have the correct details and contact information for the health and safety of everyone participating in the activities. We will store the information securely on digital files only to be accessed by relevant staff in accordance with GDPR policy. Any physical copies of contact information taken to location (for instance a print-out of emergency contact numbers) will be kept by the Skylark staff only and destroyed after the event. In addition, any photos or videos taken will be stored securely only to be access by relevant staff and we will respect your right to withdraw your consent to photographs/stories being used before publication. To do so, please contact our Volunteer Coordinator, Jade directly on 07939664921 or email skylarkvol@alternativeswd.org ASAP.

Other personal information like your location or gender identify is information gathered as part of our equality monitoring/report writing and will be kept anonymous. These details do not have to be given if you don't feel comfortable to.

To secure your space please now fill out this form!

Kind Regards,

Jade West (Volunteer Coordinator)

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Date of birth *
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Address *
Your contact phone number *
Your email address *
Emergency contact, name, phone, address, relationship to you? *
Any allergy, health or accessibility issues we need to be aware of? *
Gender
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Your ethnic origin?
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Please let us know and provide details if you need any support with regards to travel and transport on the day of the sessions. We can support you with this.
Consent *
Required
Preferred method of contact *
I am happy to be contacted after the event to participate in an evaluation session to support The Skylark IX Recovery Trust's future programmes and delivery of activity? (details will be sent nearer the time using your preferred method of contact). *
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