IDMF ENROLMENT FORM April 2023

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Participant Recruitment Form

Email *

Participant First Name *

Participant Last Name *

Age *

Activities

There are different activities on offer! Which one are you enrolling for?

Please tick the activities that you are signing up for (tick as many as you'd like!) *

ART STARS Saturday art school (ages 10-13)

YOUNG MAKERS After-school creative activities at Rosetta Arts (for ages 13-16)

MENTORING Getting one-to-one mentoring from a creative professional

YOUTH BOARD Having your say on creating I Design My Future, Rosetta's work, and what should happen in Newham (13-18)

SUMMER PROJECT Taking part in a public art project with other young people (any age)

CREATIVE EVENTS Attending events to learn about creative careers (any age)

Required

Please tick the creative areas you are interested in (tick as many as you'd like!) *

Painting

Drawing

Writing

Performing

Music - playing instruments

Music - electronic

Music - DJing/radio

Ceramics

Mosaics

Textiles

Installation

Photography

Fashion

Other:

Required

More Information about you

To get you enrolled we need the following information - the form is as short as we can make it, but please let us know if you have any issues filling it out and we can lend a hand - admin@rosettaarts.org
As I Design My Future is funded by the Mayor of London’s Young Londoners Fund some of these questions are personal. This is so that we can ensure we give equal opportunities to all, but please opt out of anything you do not wish to share.

Date of Birth *

YYYY

What gender do you identify as? *

Ethnicity *

Residential Address *

Residential Postcode *

Residential Borough *

Phone/Mobile *

Parent/Guardian Information

Name of Parent or Guardian *

Parent/Guardian Phone/Mobile *

Parent/Guardian Email Address *

Does the participant consider themselves to have a long term disability, health problem or learning difficulties? *

Yes

Prefer not to say

Please Provide more details about the long term disability, health problem or learning difficulties

Is the participant a Looked After Child/Care-Leaver *

Yes

Prefer not to say

How We Use Your Personal Information

How We Use Your Personal Information: The personal information you provide will only be used for the purpose of the above stated project by Rinova Ltd and Rosetta Arts and kept on file for the duration stated by the funding providers. The information will be passed to the relevant project partners and the relevant funding agencies. Further information about use of and access to your personal data, and details of organisations with whom we regularly share data are available at: https://rosettaarts.org/privacy-policy/ Information given on this form is covered under the Data Protection Act 1998 and GDPR. You have a right to see the information which is being held about you. Information may also be shared with your agreement with other organisations providing learning, support and employment opportunities.

I agree to take part in I Design My Future opportunities and certify that the above information is correct and I have given consent for me or my child's personal information to be used for the purposes of this project. *

I Agree

Consent for Filming and Photography

I consent to Rosetta Arts & Rinova Ltd using photographs and/or video recording including images of me or my child to promote Rosetta Arts & Rinova Ltd and/or used as part of Rosetta Arts & Rinova Ltd’s projects/programmes both internally and externally. These images could be used in print and digital media formats including print publications, websites, e-marketing, posters & banners, advertising, film, social media, teaching and research purposes.

I understand that images on websites can be viewed throughout the world and not just in the United Kingdom and that some overseas countries may not provide the same level of protection to the rights of individuals as EU/UK legislation provides.

I have read and understand the conditions and consent to my images being used as described.

Rosetta Arts committed to processing information in accordance with the General Data Protection Regulation (GDPR). The personal data collected on this form will be held securely and will only be used for administrative purposes.

Your rights
You have the right to request to see a copy of the information we hold about you and to request corrections or deletions of the information that is no longer required. You can ask Rosetta Arts & Rinova Ltd to stop using your images at any time, in which case it will not be used in future publications but may continue to appear in publications already in circulation.

Contact details
If you have any questions relating to this consent form or the way we are planning to use your information please contact Rosetta Arts on 020 7511 1117.

Data/Image consent *

I DO consent to my/my child's image and data being used in the ways described above

I DO NOT consent to my/my child's image and data being used in the ways described above

Required

A copy of your responses will be emailed to the address you provided.

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