Streetreach 2019 Application
Streetreach is the local, missional experience for young people in the Connor Diocese.
We will be partnering with Mossley Parish in Newtownabbey.
Streetreach runs from Tuesday 2nd July to Friday 5th July 2019.

Residential Applications are open for young people who have completed Fourth Year / Year 11. These places are LIMITED & will be allocated on a first come, first serve basis. It is £50 to attend.

Non-Residential Applications are open for young people who have completed First Year / Year 8.
For attending each day the cost is £10.

All over 18's are invited to apply to serve as a Team Leader or as a participant.


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Name *
Date of Birth *
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/
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Residential or Non Residential *
Required
Address including Postcode *
Email Address (By providing an email address below, you give permission for it to be stored & used for communication regarding Streetreach, its activities, as well as related activities which Streetreach seeks to promote awareness of) *
Parish *
If over 18, are you willing to serve as a Team Leader?
Parent/Guardian Full Name (under 18's only)
Emergency Contact Number & Relationship *
Any allergies / medical conditions / medications:
Please tick your preferred interests (Whilst we will try to accommodate preferences, please be aware that needs may require us to place you in alternate areas)
Clear selection
What is your preferred t-shirt size? *
Have you told your clergy that you will be taking part in Streetreach? *
Do you give consent for photographs or videos to be taken and used? (Photographs will be taken for publicity purposes & used online and in print) *
Required
Please provide the name & email of 2 mature Christians who will commit to praying for you in the lead up and during Streetreach. By providing their email, they agree to be contacted with prayer updates during Streetreach & to receive an invitation to the Commissioning Service.
Prayer Sponsor #1 Name *
Prayer Sponsor #1 Email *
Prayer Sponsor #2 Name *
Prayer Sponsor #2 Email *
Have you completed an Access NI & Safeguarding Trust Training through your parish? (only for those aged 18 and over)
Payment Options: payment for residential or day trips are required before Streetreach commences. *
Parental Permission (Only for under 18 applications): I confirm that details declared are complete and correct to the best of my knowledge. In the unlikely event of an accident, I give permission for any appropriate first aid to be given by the nominated first aider. In an emergency, and I cannot be contacted, I am willing for my child to be given hospital treatment, including anaesthetic if necessary. I understand that every effort will be made to contact me as soon as possible. By writing my name below, I agree all the information above is accurate and I give permission for my child to attend Streetreach:
By confirming below, you are agreeing to consent to Connor Diocese holding and processing your personal data for the purposes of contacting you about Streetreach, planning and administration for the event. *
Required
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