Name *

First Name

Last Name

Please confirm whether you are over 18 years old *

Please select one option

Yes I am 18 years old or over

No I am under 18 years old

Do you consider yourself to have a disability? *

The Disability Discrimination Act 1995 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial long-term adverse effect on his or her ability to carry out normal day-to-day activities’.

Yes

No

Please also detail below any other information that BiG needs to be aware of to make your experience engaging in a BiG Youth Engagement event the best it can be for you! *

No other information to provide

Visual impairment

Hearing impairment

Physical disability

Learning disability

Multiple disability

Other

CONSENT* Please select all the following options where you personally consent (or on behalf of your child if they are under 18 years old) to your / there pictures, and where you (they if under 18 years old) appear in video clips to appear on / in the BiG C.I.C.: (THIS IS A REQUIRED FIELD SO IF YOU DO NOT CONSENT, PLEASE SELECT "I DO NOT CONSENT") *

BiG C.I.C will be recording all of its online activities and programmes for training and marketing purposes. We will use recordings to edit and produce marketing films and material and create still shot images, and will post on the BiG C.I.C. website, other social media platforms, and publish in promotion / training material.

I do not consent

Website

Instagram

Twitter

Facebook

Youtube Channel

TiKTok

Promotion material

Training material

Consent *

Please confirm consent condition from the following

I am 18 years old and over and completed the consent section myself

I am 17 years old and younger and my parent / carer has completed the consent section