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Application for Chill Zone group
Chill Zone is a new group launching soon for children and young people aged 13+ with anxiety and other low-to moderate mental health issues. Please apply now to reserve a space.
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Email
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Name
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Date of Birth
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Current year group at school / college
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Home address
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What do you hope to get from the group?
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Who will be bringing you?
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Name of Emergency contact
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Relationship to young person
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Telephone number of emergency contact
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Please provide name, address and phone number of doctor you are registered with
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Please provide details of any allergies or health conditions, such as asthma that you have, with details of any emergency treatment (eg epi-pen, inhaler) that you may need to use
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I consent to Y:AMHS Volunteer Staff accessing emergency medical treatment if they are unable to contact me (To be signed by parent/ guardian/ emergency contact)
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In order to ensure the safety and comfort of all participants, we would ask that all young people agree to 1) Treat leaders and others with respect 2) No use of alcohol or drugs prior to or during the group session and no use of cigarettes or vapes during the group session 3) No photographs which include other members of the group without their consent 4) Please let the team know if you are unable to come to a session by calling or texting Y:AMHS on 07897 835317 or emailing
info@yamhs.co.uk
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