Radical Hearts, Open Minds – Adult and Family Form

Quaker Life – Radical Hearts, Open Minds Interest Form

Step 1 of 5

Expression of Interest form

This form will take around 7-10 minutes to complete. You will need:

– contact information

– a recent photograph if you or anyone in your group doesn’t want their image to be used for publicity purposes

This form is an expression of interest to attend these events. As this forms part of the consultation process on “Approaches for the Future – Faith, Inclusion and Growth”, staff will be reviewing applications to make sure there is a good cross section of people representing different groups and areas. We will confirm your place as soon as possible.

Please confirm that you have read the event information page and the two documents, Further Information, and Community Agreement, which you will find there before filling in this form. This gives further details of the practical arrangements, programme, payment and FAQs.

Consent and Information

This form is now only for the final session, online on Saturday 22nd November. Please use the “Late bookings” location, and we will confirm if you have a place. Please read the guidance and complete the form as requested. This Information and Consent form covers information required for insurance purposes and enables the effective planning and running of events.

This form will be handled, and the data will be stored, in electronic and paper forms in accordance with BYM Polices.

All participants need to agree to abide by the stated community agreement during the event, and accept responsibility for the consequences of any breaking of this community agreement (which may include being asked to leave the event).

Please e-mail QLAdmin@quaker.org.uk with any queries.

Event Location(Required)

Name(Required)

First Last

Mobile Phone

Landline Phone

Email(Required)

Address(Required)

Street Address Address Line 2 City Post Code

Area Meeting(Required)

Are you the Quaker Life Representative Council Rep for your Area meeting?(Required)

Yes

No, but I have been nominated by my area meeting instead of a Quaker Life Representative

Children and Young People

Please fill in the fields below if you are planning on bringing someone under the age of 18 along with you. (There is a separate form if you are between 11 and 18 years old and planning on attending unaccompanied)

This online event is not open to people under the age of 18.(Required)

Please move onto the next section

Yes

What Relation do you have with the under 18s?

Please know that by agreeing to bring young people to this event, you take responsibility for them and you must know that you would require contact information for the child’s legal guardian if that is not yourself.

Other?

First Child Name

First Last Age

Second Child Name

First Last Age

Third Child Name

First Last Age

Fourth Child Name

First Last Age

Any Details about your young people (Inc. Dietary and Participation Needs)

Use of Data

In accordance with the UK Data Protection legislation and EU General Data Protection Regulation, permission must be granted by the parent/guardians or participant (if over 18) before any images may be taken and used, and for how the personal data can be used.

Quakers in Britain uses photography and video to attract new members, encourage people to take part in our activities and contribute to our funds.

Please indicate whether you give your consent for videos, images and audio of you/your child/ward to be used for these purposes in all of the following: print, website, e-books, other electronic formats and social media (Facebook, Twitter, etc.).

We do not identify people by name or meeting without specific, prior permission. We will not identify children and young people under the age of 18 by name, local meeting or where they live.

Some images or recordings may be kept permanently once they are published and archived by the organisation.

We may use images on collaborative work with other organisations e.g. Woodbrooke.

These will be the copyright of Britain Yearly Meeting (the legal name for Quakers in Britain), and any other intellectual property which arises in the recordings will also belong to Britain Yearly Meeting.

I can ask Quakers in Britain to stop using my images at any time, in which case they will not be used in future publications but may continue to appear in publications already in circulation (contact BYM Data Safety Group to discuss at datasafety@quaker.org.uk)

I can complain about the use of my image/audio by contacting Quakers in Britain Data Safety Group at datasafety@quaker.org.uk

Image Consent(Required)

Do you actively consent to the the participant’s image being used under the above conditions?

Should you wish to withdraw your consent at any time, please contact: qladmin@quaker.org.uk

Yes

Video Consent(Required)

Do you actively consent to audio/video recordings the participant’s being used under the above conditions?

Should you wish to withdraw your consent at any time, please contact: qladmin@quaker.org.uk

Yes

Picture

If your answer was no, we need a record of what you, and/or the child or young person look like. We do our best to ensure they are not in any pictures, video or audio taken at the event. We can then also delete any media taken during the event in which they appear.

Please upload a photo. If you need to send any other photos, send them directly to qladmin@quaker.org.uk

Max. file size: 32 MB.

Data Consent(Required)
Do you actively consent to the contact information you have provided being used to send promotional information about future events and opportunities?
Should you wish to withdraw your consent at any time, please contact: qladmin@quaker.org.uk
Yes
No

Payment
You do not need to pay now. We will send you payment details when your place has been confirmed.
Adult Ticket (26+) Quantity

Price: £ 25.00

Online Adult Ticket Quantity

Price: £ 10.00

Young Person Ticket (0-25) Quantity

Price: £ 0.00

Total

QForms

Online forms and surveys from quaker.org.uk

Radical Hearts, Open Minds – Adult and Family Form

Quaker Life – Radical Hearts, Open Minds Interest Form

Expression of Interest form

Consent and Information

Participant Needs

Children and Young People

Use of Data

Payment