The Big Speak Out 2020 Booking Form

The URC Youth Logo

Booking form for participants
Age: 11 to 18 years inclusive

Welcome to the Big Speak Out registration page. Please fill in all the fields before 29th May 2020.

Attendee Details

First name(s): (*)
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Surname:(*)
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Known as (for name badge):(*)
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Gender:(*)
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Address
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Postcode:(*)
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Telephone number:(*)
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Email:(*)
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Date of birth:(*)
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Age (on 24/7/20):(*)
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Church name (if applicable):
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URC Synod (or Denomination/Group):(*)
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Member of Pilots:(*)
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Name of company (if applicable):(*)
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Pilots leader name and email (if applicable)
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Youth group leader name and email (if applicable)
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Do you give permission for your youth leader or Pilot captain to be contacted about your participation and travel arrangements.
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Next of kin – emergency contact during event
First name(s):(*)
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Surname:(*)
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Email address:(*)
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Relationship:(*)
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Telephone number:(*)
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Mobile number:(*)
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Travel
How will you be travelling to The Big Speak Out?(*)
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Other form of travel:
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Anticipated time of arrival:
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Special requirements
Do you have any special dietary requirements (including vegetarian/vegan, allergies, intolerances, etc.)?
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Do you have a disability?
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If so, please tell us more:
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Is there anything we can do to help or support you?
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Costs
If money is an issue, please contact us on 020 7916 8637 or e-mail children.youth@urc.org.uk as financial support is available.

The cost of attending The Big Speak Out 2020 is:
Early bird bookings before 5pm Monday 30th March 2020 £69
Bookings after 5pm Monday 30th March 2020 to 28th May 2020 £85

Please tell us how your costs will be paid: *complete as appropriate
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Cheque amount: £
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Please invoice:
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Please note that by submitting this form, you are making a firm booking for The Big Speak Out 2020. If you wish to cancel this booking, please contact the Children’s and Youth Work office by 27 May 2020 or you will be charged the full amount.

Ethnic diversity.
The Big Speak Out 2020 is a safe and welcoming place for all, whatever your background or wherever you come from. Please help us to make this happen by telling us about your ethnicity.
I am:
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White Other:
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Black Other:
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Other (please specify):
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If you or your group need a leader to accompany you, please get in touch directly with the Children's and Youth Office on 020 7916 8683 or children.youth@urc.org.uk

The Children's and Youth Office data privacy notice can be found here.