Histon Babysitting Sign-Up

Babysitting Course Sign-Up Form

Please select which venue you are signing up for: *

Histon & Impington

Cottenham

Name of Young Person (first and surname) *

Date of Birth *

Address & Postcode *

Email *

Mobile Phone (young persons) *

Gender *

Female

Male

Other

School Attended and Year Group *

In an emergency, who can we contact? (Name, Relationship to young person, Mobile Number) *

Text *

Any medical condition/information we might need to know?

Payment *

I will pay £20 (when place is confirmed) by bank transfer to The Connections Bus Project, Cooperative Bank 08-92-99 A/C No. 67311538 (please reference “BS (young person name)”)

Photo/Video Permission – Whilst young people are taking part in FIrst AId part of the course we occasionally like to record an event or activity by taking photographs or using a video camera. The images may be used for reports, displays etc or even just as memories for the young people. We are aware of the sensitivity surrounding this issue and therefore will not photograph/video any young person without the consent of their parent/carer.

I give consent for my child/ward to be photographed/videoed during the normal course of the actvity.

If you are human, leave this field blank.