2021 CYP Summer Series Online Quaker Youth Group 2021 CYP Summer Series Online Quaker Youth Group Step 1 of 5 20% 1) About the participantName * Required First Last Preferred name * Required PronounWe would like to adopt a culture where the gender pronoun an individual is comfortable with is not assumed. If you are comfortable doing so please let us know the pronoun you use. Participant's Date of Birth - must be dd/mm/yyyy format * Required DD slash MM slash YYYY Participant's age * RequiredOn 1 September 20201112131415161718Participant's email * Required Participant's mobile phone number * Required Note: We will only use phone contact details in case of emergency. Participant's address * Required Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Community agreement * RequiredPlease read the community agreement which is here. You should then indicate your agreement to this and uphold this in how you conduct yourself during the event. I agree Quaker CommunityIf you or your family are connected to a Local, Area or Yearly Quaker Meeting please add details here. 2) Participant's needsSupportIs there anything you would like to let us know about that would support your wellbeing or participation in the group? Any information which you provide will be treated in confidence. However, if we are concerned that you or someone else is at risk of harm, we may need to take action in response to these concerns. 3) Parent or Guardian contact detailsThis is so that we can ask for their permission for your participation in the online group. Also so we can be in touch in case of concern about a young person. Name * Required First Last Relationship to you * Requirede.g. mother, father, guardian etc Parent or Guardian's Email * RequiredPlease provide an email address that they use regularly so that we can contact them. Parent or Guardian's contact telephone number: * Required Note: we will only use phone contact details in case of emergency. Participant's Doctor's surgery. Name, address and contact telephone number. * RequiredNote: We will not normally contact the GP and will only do so if we assess the young person as being at serious risk of harm to themselves. If this is the case then we should explain this to the young person and their parent/guardians, unless doing so would put the young person at further risk. If they are sharing information they should tell you how they will be recording this concern, who they will inform and what will happen next. PromotionPlease state how you heard about this opportunity.