Surname/Family Name Date of Birth Scotland / / Northern Ireland Home Address Wales Postcode North East Parent or guardians email North West Parent or guardians tel/mobile Yorkshire and The Humber School East Midlands West Midlands Gender (please Male Female tick) East You and your membership South East Member Status BWB Member New Member London (please tick) South West Main Club (where applicable) Emergency Contact Does your child have any allergies or medical conditions Name of emergency contact Disability Relationship to young person Contact number Which Skills Camp will you be attending? Region Skills Camp Young Activators Course
Surname/Family Name Date of Birth / / Home Address Postcode Parent or guardians email Parent or guardians tel/mobile School Gender (please tick) Male Female You and your membership Member Status (please tick) BWB Member New Member Main Club (where applicable) Does your child have any allergies or medical conditions Disability Which Skills Camp will you be attending? Region Skills Camp Young Activators Course Scotland Northern Ireland Wales North East North West Yorkshire and The Humber East Midlands West Midlands East South East London South West Emergency Contact Name of emergency contact Relationship to young person Contact number
Skills_Camp_and_Young_Activator_Registration_and_Consent_Form.docx