Youth Trainer Programme Sign Up Form

Date *

Please add todays date

What class are you signing up for?

Tuesday 5-6pm
Friday 5-6pm
Friday 6-7pm

Mr/Mrs/Miss/Ms/Dr/Other

Student Name *

First

Last

Please add your childs name here.

Parent/Guardians Name *

First

Last

Please add your name here.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number

Mobile Phone *

Email *

Please enter your email address.

How did you hear about Barking Buds Youth Trainer Programme? *

What benefits are you hoping your child will get from the programme? *

For example: More confidence, More social, Fun, Make new friends, Further their passion...

Emergency Contacts

In the event of an emergency please give 2 contact names and phone numbers. So we are able to contact them if needed when a student isn’t able to contact them by themselves, also so we know who we are contacting on their behalf

Name of First Emergency Contact *

First

Last

Relationship to Student

Contact Number

Name of Second Emergency Contact *

First

Last

Relationship to Student

Contact Number

Medical Conditions

Please answer all questions below honestly so we can make sure we keep your child safe.

It is important that the information given is accurate and to discuss with the main instructor any medical conditions or medication the student may have. Please tick this box to allow us to share this information with other Barking Buds Trainers. It is important that the information given is accurate and to discuss with the main trainer any medical conditions or medication the student may have. Please tick this box to allow us to share this information with other Barking Buds Trainers. *

Does your child have any medical conditions? *

If yes, please give more information.

Is your child on any medication? *

If yes, please give more information

Is there anything else we need to know about your child that may affect how they are whilst with Barking Buds? *

This could be anything from anxiety to need of a service animal. If there is nothing please type no.

I give permission for First Aid to be administered in the event of an emergency. For assistance to be given in use of students’ own medication when needed. Also for a First Aider to phone an ambulance in an emergency prior to phoning a relative. I have answered all questions truthfully to the best of my knowledge and I understand that as we are working with dogs there is always a small chance of injury during training. I understand that if my childs health or circumstances change I will need to inform a member of staff or a trainer immediately. *

Yes, I give permission

If you do not give permission please speak to one of our Trainers.

General Data Protection Regulations (GDPR)

Please click opt in or out for all of the following.

Enable us to keep all of the details you have filled in above to keep in contact with you.

Keep you updated about what is happening in classes and what is happening at Barking Buds.

Allow us to keep the medical information for first aid purposes as well as needing to share with an ambulance in the unlikely event.

Keeping your child safe and ensuring we can treat them immediately.

I give permission to receive emails and other correspondence from Barking Buds.

Keeping you updated about the whole of Barking Buds and what we can offer you and your family. You will not be spammed with emails! There is usually one email every few months.

I give permission for my child to have photos or videos taken of them to go on social media, leaflets, posters, case studies, internal and external use.

If there is one or two things you do not give permission to please let a trainer know and they can note it down.

Please type your initials if you agree with the statement below.

In the event of you or your child leaving the academy all the above data will be deleted as much as possible from our records. Any photographs taken of the students will no longer be used but may still remain saved onto our cloud or hard drive storage and may still remain on social media, our web site and any other digital platform they might have been uploaded to. I have read and fully understand the whole of this form and am happy with my decisions, I understand I can change my mind at any time and request a new form to fill in with my revised wishes. I understand that by typing my initials above this is me giving my permission.