URCYA 2020

Header for web form


Booking Form





Welcome to the United Reformed Church Youth Assembly registration page. Please fill in all fields below and book before 1 January 2020.

The age range for this event is Year 10/S3 to 25 years inclusive.

For further information on how your personal information is processed, please visit https://www.urc.org.uk/images/Children-and-youth/documents/CYW_Data_Privacy_Notice.pdf for our Data Privacy Notice.






Invalid Input


Attendee Details




First Name(s):\

Invalid Input

Surname:\

Invalid Input

Known as (for name badge):\

Invalid Input

Gender:\

Invalid Input

Address:\

Invalid Input

Postcode:\

Invalid Input

Telephone Number:\

Invalid Input

Email:\

Invalid Input

Date of Birth:\

Invalid Input

Age (on 24/01/2020):\

Invalid Input

Church Name (if applicable):

Invalid Input

Synod (or Denomination/College):

Invalid Input

Have you been to Youth Assembly before?\


Invalid Input


Next of Kin




First Name(s):\

Invalid Input

Surname:\

Invalid Input

Relationship:\

Invalid Input

Email Address:\

Invalid Input

Telephone Number:\

Invalid Input

Mobile Number:\

Invalid Input


Travel




How will you be travelling to Youth Assembly?\




Invalid Input



Invalid Input

Day of arrival:\



Invalid Input

A coach will be provided from Tamworth train station to Whitemoor Lakes on Friday 24 January 2020 and returning from Whitemoor Lakes to Tamworth train station on Sunday 26 January 2020. Will you need a seat on the coach?\





Invalid Input


Requirements




Do you have any special dietary requirements?:







Invalid Input



Invalid Input

Do you have an impairment?\

Invalid Input

If yes, please tell us more:

Invalid Input

Is there anything we can do to help or support you?

Invalid Input

Do you have a particular wellbeing need that you would like our team to know about?:

Invalid Input


Costs





If money is an issue, please contact us on 020 7916 8683 or e-mail children.youth@urc.org.uk as financial support is available.



The cost of attending the URC Youth Assembly 2020 is:

£110 (on or before 11 November 2019)
£140 (on or after 12 November 2019)




Please tell us how your costs will be paid:




Invalid Input


Band at Youth Assembly





Please tell us if you would be willing to share musical gifts


I wish to be a part of the music group at Youth Assembly 2020:




Invalid Input

I play the:

Invalid Input


Ethnic Diversity





URC Youth Assembly is a safe and welcoming place for all young people, whatever their background or wherever they come from. Please help us to make this happen by telling us about your ethnicity.

I am:




Invalid Input

White Other:

Invalid Input

Black Other:

Invalid Input

Other:

Invalid Input


Room Details





Most rooms have four beds (usually two singles and one bunk bed). If you would like to share with a friend(s) of the same gender (same or similar age – please note that under and over 18s will be in separate rooms), please state their name(s) below and we will do our best to match you up.


I would like to share with:

Invalid Input


Small Groups




This year at Youth Assembly, the small groups will all take place in the main hall. Please inform us below of any particular needs or preferences that might require a different environment to enable you to participate:

Invalid Input

Is there a particular person you would benefit being in a group with?:

Invalid Input


Creche




A creche will be provided for participants’ children aged 0 to 5 inclusive. If you would like a creche place for your child, please indicate below and for how may children:

Invalid Input

Place(s) at £10.00 each (for 0 to 3 year olds):

Invalid Input

Place(s) at £55.00 each (for 4 to 5 year olds):

Invalid Input


A separate booking form will be sent to you.



Other Questions




Paperwork for this event will be available online (via an emailed link). If you wish to receive a hard copy of the papers by post, please indicate below:


Invalid Input


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


Spam Test

Invalid Input