Yorkshire Quaker Camp Adult Booking Page 2025 Yorkshire Activities Consent & Information form for Adults on Residential events A one-time form that covers an adult for Quakers in Yorkshire residential events Step 1 of 2 50% Consent and information formAbout you.We need to collect some further information about each person attending the camp, to help us with planning, safety and evaluation. Please complete this form about yourself, and ensure that each person in your group completes their own form.Your name* If you are part of a Quaker community, what is it?Eg, a local or area meeting, YFGM or a Quaker recognised body. Date of Birth* DD dot MM dot YYYY Your genderPlease state. Your ethnicity Dietary informationDietary choices* Omnivore Vegetarian Vegan Vegetarian plus fish (pescatarian) Does you have any food allergies and intolerances?* Yes No How would you rate the severity of the allergies/intolerances?*Examples: Lethal - a peanut allergy for which the participant is required to carry an epi-pen. Severe - Coeliac disease for which ingestion of gluten would be a painful, residential ending, potentially hospitalising situation. Moderate - a dairy intolerance that would be uncomfortable if transgressed, but manageable . Low risk - one-offs, a bit of redness round the mouth, something you've not bothered to see the doctor about. Immediately Lethal Severe Moderate Low risk Please give details of allergies and intolerances*Triggers, proximity etc. What should we do if you have an allergic reaction?*Adrenaline auto-injectors, antihistamines, that kind of thing... Physical medical/other needsAre you disabled?* Yes No Do you have any medical/additional/special needs we need to know about so that you can have a safe and happy time?* Yes No Please give details*Your NHS numberWe collect this so it can be shared with medics in an emergency. Emergency contactsThis information enables us to contact those who need informing in the event of an emergency. Emergency contact*The person you would want us to contact for you in an emergency. First Last Emergency contact: Phone number (mobile)* Emergency contact: Phone number (landline) Use of dataIn accordance with Data Protection, we need your permission before any images can be taken and used. Quakers in Yorkshire uses images of Quakers to attract new members and encourage people to take part in our activities. Please indicate whether you give your consent for your image to be used in printed materials and on our website, social media channels and in videos. We will not identify anyone by name or meeting. Some materials may be created with partnership organisations. Should you wish to withdraw your consent to the following at any time, please contact Jo Baynham at: Jonathonb@quaker.org.ukImage consent*Can we take and use pictures of you for publicity purposes? Yes No Secure Link Start Booking for Another Adult Start Booking for an Under 18 Year Old Click this link to start a booking for another adult. Don't forget to come back and click SUBMIT on this one! NameThis field is for validation purposes and should be left unchanged.
